Authors: Sanne MBI Botden Sonja N Buzink Marlies P Schijven Jack J Jakimowicz
Publish Date: 2007/03/08
Volume: 31, Issue: 4, Pages: 764-772
Abstract
Virtual reality VR is an emerging new modality for laparoscopic skills training however most simulators lack realistic haptic feedback Augmented reality AR is a new laparoscopic simulation system offering a combination of physical objects and VR simulation Laparoscopic instruments are used within an hybrid mannequin on tissue or objects while using video tracking This study was designed to assess the difference in realism haptic feedback and didactic value between AR and VR laparoscopic simulationThe ProMIS AR and LapSim VR simulators were used in this study The participants performed a basic skills task and a suturing task on both simulators after which they filled out a questionnaire about their demographics and their opinion of both simulators scored on a 5point Likert scale The participants were allotted to 3 groups depending on their experience experts intermediates and novices Significant differences were calculated with the paired ttestThere was general consensus in all groups that the ProMIS AR laparoscopic simulator is more realistic than the LapSim VR laparoscopic simulator in both the basic skills task mean 422 resp 218 P 0000 as well as the suturing task mean 415 resp 185 P 0000 The ProMIS is regarded as having better haptic feedback mean 392 resp 192 P 0000 and as being more useful for training surgical residents mean 451 resp 294 P 0000There is consensus that education in minimally invasive surgery should be intensified and that more objective assessment of surgeons’ skills should be introduced to ensure highquality treatment3 The growing need for training in advanced laparoscopic skills outside the operating room and continued advances in computer technology have led to growing interest in the development of virtual reality VR simulators12 Another simulator system is augmented reality AR which refers to systems that merges computer graphics and real imagery into a single coherent perception of an enhanced world around the user This means that the image one sees on the simulator screen is comprised of a real video image overlaid with a graphics image This can for example be used for directional explanationAccording to various studies234 force tactile feedback is fundamental for good laparoscopic training and results in significantly improved skills transfer to the trainee compared with training without force feedback2 AR laparoscopic simulators have realistic force feedback because the operator practices on real objects or tissue using surgical laparoscopic instruments Objective performance assessment is fundamental to provide formative feedback during training though conventional box trainers lack this ability AR laparoscopic simulators retain the benefits of a box trainer such as the realistic haptic feedback but additionally generate objective measures of performance similar to VR simulators1This study focused on training simulation and skills assessment in laparoscopic surgery Because of the importance of both force feedback and objective assessment we compared the ProMIS Haptica AR laparoscopic simulator with the LapSim Surgical Sciences VR laparoscopic simulator Issues such as realism didactic value haptic feedback and user acceptance were validated by participants The purpose of this study was to evaluate which training system is of more value in curricula for surgical residents in laparoscopic skills training
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