Center for Thoracic Surgery, Department of Medicine and Surgery, University of Insubria, Via Guicciardini, 9, Varese, 21100, Italy.
Center for Minimally Invasive Surgery, Department of Medicine and Surgery, University of Insubria, Varese, Italy.
BMC Med Educ. 2023 Jul 27;23(1):535. doi: 10.1186/s12909-023-04482-z.
Video-assisted thoracic surgery (VATS) has become the standard for lung cancer diagnosis and treatment. However, this surgical technique requires specific and dedicated training. In the past 20 years, several simulator systems have been developed to promote VATS training. Advances in virtual reality may facilitate its integration into the VATS training curriculum. The present review aims to first provide a comprehensive overview of the simulators for thoracoscopic surgery, focused especially on simulators for lung lobectomy; second, it explores the role and highlights the possible efficacy of these simulators in the surgical trainee curriculum.
A literature search was conducted in the PubMed, EMBASE, Science Direct, Scopus and Web of Science databases using the following keywords combined with Boolean operators "AND" and "OR": virtual reality, VR, augmented reality, virtual simulation, mixed reality, extended reality, thoracic surgery, thoracoscopy, VATS, video-assisted thoracoscopic surgery, simulation, simulator, simulators, training, and education. Reference lists of the identified articles were hand-searched for additional relevant articles to be included in this review.
Different types of simulators have been used for VATS training: synthetic lung models (dry simulators); live animals or animal tissues (wet simulators); and simulators based on virtual or augmented reality. Their role in surgical training has been generally defined as useful. However, not enough data are available to ascertain which type is the most appropriate.
Simulator application in the field of medical education could revolutionize the regular surgical training curriculum. Further studies are required to better define their impact on surgeons' training programs and, finally, on patients' quality of care.
电视辅助胸腔镜手术（VATS）已成为肺癌诊断和治疗的标准。然而，这种手术技术需要特定的、专门的培训。在过去的 20 年中，已经开发出几种模拟器系统来促进 VATS 培训。虚拟现实的进步可能会促进其纳入 VATS 培训课程。本综述的目的首先是全面概述胸腔镜手术模拟器，特别是针对肺叶切除术的模拟器；其次，探讨这些模拟器在外科学员课程中的作用和突出可能的疗效。
在 PubMed、EMBASE、Science Direct、Scopus 和 Web of Science 数据库中使用以下关键词结合布尔运算符“AND”和“OR”进行文献检索：虚拟现实、VR、增强现实、虚拟模拟、混合现实、扩展现实、胸腔手术、胸腔镜、VATS、视频辅助胸腔镜手术、模拟、模拟器、模拟器、培训和教育。对已确定文章的参考文献进行手工搜索，以纳入本综述中的其他相关文章。
已经使用不同类型的模拟器进行 VATS 培训：合成肺模型（干式模拟器）；活体动物或动物组织（湿式模拟器）；以及基于虚拟或增强现实的模拟器。它们在手术培训中的作用通常被定义为有用。然而，没有足够的数据来确定哪种类型最合适。
模拟器在医学教育领域的应用可能会彻底改变常规的外科培训课程。需要进一步的研究来更好地定义它们对外科医生培训计划的影响，最终影响患者的护理质量。
