K. H. Perrone1, H. Mohamadipanah1, J. Nathwani2, C. Parthiban2, K. Peterson2, B. Wise1, A. Garren2, C. Pugh1 1Stanford University,Palo Alto, CA, USA 2University Of Wisconsin,Madison, WI, USA
Introduction:
Laparoscopic surgery presents a unique set of technical challenges compared to open surgery and continues to account for an increasing proportion of modern surgical practice. As a result, laparoscopy is critical for trainees to master. This study investigated the possibility of using Virtual Reality (VR) perceptual-motor tasks as a screening tool for laparoscopic ability using Laparoscopic Ventral Hernia (LVH) repair as an archetypical procedure. We hypothesized that perceptual-motor skills assessed using VR will correlate with and contribute to LVH repair performance.
Methods:
Surgical residents (N=37), from seven mid-west programs, performed two perceptual-motor tasks: 1) force matching and 2) target tracking, using a haptic interface device and a VR environment. Perceptual-motor skills were quantified using motion metrics including “peak deflection on force release”, “summation of distance from sphere”, “path length” and “maximum distance from sphere”. The residents also performed a partial LVH repair on a benchtop simulator with previously demonstrated validity evidence in multiple contexts. Outcome metrics for the partial LVH repair included final product score and endoscopic visualization errors. A parametric correlational analysis was performed to assess the relationship between performance on VR tasks and LVH.
Results:
For the LVH metrics, residents with a higher number of endoscopic visualization errors had significantly lower final product scores (r = -0.52, p<0.01). When assessing the relationship between metrics in the force matching module in VR and LVH performance, residents with poor performance on “peak deflection on force release” (r = -0.344, p<0.05) and “summation of distance from sphere” (r = -0.359, p<0.05) in VR also had significantly lower final product scores. Likewise, poor performance metrics in the VR-based target tracking task including “path length” (r = -0.488, p<0.05) and “maximum distance” (r = -0.365, p<0.05) correlated significantly with lower final product scores. In addition, longer “path length” values (r = +0.375, p<0.05) had a significant correlation with endoscopic visualization errors. (Table 1)
Conclusion:
This study showed significant correlations between poor performance on VR-based perceptual-motor tasks and basic laparoscopic skills during a partial LVH repair thus supporting the notion that VR could be used as a screening tool for perceptual-motor skill among junior surgical trainees. For trainees identified as having poor perceptual-motor skill through VR, focused curricula could be created, allowing trainees to hone their personal areas of weakness and maximize technical skill to more efficiently prepare for basic and advanced laparoscopic procedures.
