Surgical endoscopy · 2025
A study comparing virtual reality simulation, 3D printed organ models and a combination of both for laparoscopy surgery skills acquisition.
СтатьяСравнительное исследованиеРандомизированное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Amadi Sidney Moses, Jing Jiyong, Nzella Rhoda, Zhihao Zhu, Qi Chen, Vadher Rakshit, Sohail Ayesha, Rayyan Muhammad, Wang Zhifei, Mao Jinlei
Аннотация
OBJECTIVE: Virtual reality (VR) simulators and 3D printed organ models are effective for laparoscopic skill acquisition independently. This study aimed to evaluate the synergistic efficacy of a hybrid training program that combines both modalities.
METHODS: Twenty-seven surgical novices, were randomized into three equal cohorts (VR, 3D, Hybrid). The hybrid cohort underwent a two-phase curriculum over 10 weeks: VR simulation for weeks 1-5, followed by the 3D model for weeks 6-10. The final task was a laparoscopic colon end-to-end anastomosis on a porcine ex vivo model, which was video-recorded for blinded OSATS assessment. Primary outcomes included OSATS scores and procedure times. Data were analyzed using ANOVA, Chi-square test, Kruskal-Wallis H test, and post hoc tests. Learning curves were assessed using CUSUM analysis, and survey data were analyzed with Wilcoxon signed-rank and Mann-Whitney U tests.
RESULTS: OSATS scores: Hybrid vs. 3D vs. VR (30.67 ± 3.464 vs. 29.00 ± 3.640 vs. 24.78 ± 2.99, P < 0.01). Procedure times were similar across groups: VR (120.33 ± 51.42 min), 3D (119.56 ± 34.04 min), Hybrid (135 ± 25.08 min). Fluid leak test: VR group showed significantly higher fluid leakage and fluid leakage flow rate than hybrid and 3D (p < 0.05). Learning curve: Hybrid had shorter curve. Instrument handling: 3D and Hybrid outperformed VR (p < 0.05). Post-training surveys: 3D and Hybrid groups reported improvements in interest in surgery and confidence in laparoscopic skills (p < 0.05). 3D cohort rated highest in confidence building, realism, and overall effectiveness (p < 0.01).
CONCLUSION: A hybrid curriculum enhances training outcomes compared to a VR-only curriculum, with 3D models showing particular strengths in optimizing skill acquisition. Integrating 3D printed models into a hybrid curriculum may shorten the learning curve and better prepare trainees for complex surgical tasks, expanding access to effective laparoscopic training.
METHODS: Twenty-seven surgical novices, were randomized into three equal cohorts (VR, 3D, Hybrid). The hybrid cohort underwent a two-phase curriculum over 10 weeks: VR simulation for weeks 1-5, followed by the 3D model for weeks 6-10. The final task was a laparoscopic colon end-to-end anastomosis on a porcine ex vivo model, which was video-recorded for blinded OSATS assessment. Primary outcomes included OSATS scores and procedure times. Data were analyzed using ANOVA, Chi-square test, Kruskal-Wallis H test, and post hoc tests. Learning curves were assessed using CUSUM analysis, and survey data were analyzed with Wilcoxon signed-rank and Mann-Whitney U tests.
RESULTS: OSATS scores: Hybrid vs. 3D vs. VR (30.67 ± 3.464 vs. 29.00 ± 3.640 vs. 24.78 ± 2.99, P < 0.01). Procedure times were similar across groups: VR (120.33 ± 51.42 min), 3D (119.56 ± 34.04 min), Hybrid (135 ± 25.08 min). Fluid leak test: VR group showed significantly higher fluid leakage and fluid leakage flow rate than hybrid and 3D (p < 0.05). Learning curve: Hybrid had shorter curve. Instrument handling: 3D and Hybrid outperformed VR (p < 0.05). Post-training surveys: 3D and Hybrid groups reported improvements in interest in surgery and confidence in laparoscopic skills (p < 0.05). 3D cohort rated highest in confidence building, realism, and overall effectiveness (p < 0.01).
CONCLUSION: A hybrid curriculum enhances training outcomes compared to a VR-only curriculum, with 3D models showing particular strengths in optimizing skill acquisition. Integrating 3D printed models into a hybrid curriculum may shorten the learning curve and better prepare trainees for complex surgical tasks, expanding access to effective laparoscopic training.