Virtually Augmented Surgical Navigation in Endoscopic Sinus Surgery Simulation Training: A Prospective Trial of Repeated Measures.

OBJECTIVE

The objective of this study was to explore the educational utility of virtually augmented surgical navigation (VASN) in simulation training for endoscopic sinus surgery.

STUDY DESIGN

Prospective trial using within-subjects design.

SETTING

Single academic institution.

METHODS

Otolaryngology trainees (n = 15) were enrolled in a prospective trial of repeated measures. Participants performed unilateral functional endoscopic sinus surgery (FESS) on a 3-dimensional-printed sinus model without instruction. Participants then underwent educational intervention incorporating VASN tools-featuring anatomic overlay delineations, virtual planning points, proximity alerts, digital measurements, as well as artificial intelligence-generated endoscopic viewpoints. With the VASN tools activated, participants then performed FESS on the contralateral side of the model. Primary outcomes of interest included number of major complications, time to complete anterior fess, steps completed, and technical skills score. Descriptive statistics were performed to describe participant characteristics and bivariate analysis were used to evaluate differences in subjective and objective outcome measures.

RESULTS

A majority (93%) of residents strongly agreed that simulation intervention improved their confidence in surgical skills related to FESS. Complications decreased from 13 instances to 3 following interventions. Initial technical skills score of 45.2 increased to 54.4 postintervention (P < .0001) and global score also improved by 4.6 points on average (P < .001). Time to anterior FESS decreased from 1356 to 915 seconds (P = .006) and average number of completed surgical steps increased from 3.3 to 4.6 (P < .001).

CONCLUSION

This simulation study contributes to growing evidence supporting utility of advanced technology in surgical education. Results suggest that VASN serves as a beneficial adjunct in FESS simulation training.