Stress responses in surgical trainees during simulation-based training courses in laparoscopy.

Background: Simulation-based training courses in laparoscopy have become a fundamental part of surgical training programs. Surgical skills in laparoscopy are challenging to master, and training in these skills induces stress responses in trainees. There is limited data on trainees' stress levels, the stress responses related to training on different laparoscopic simulators, and how previous experiences influence trainees' stress response during a course.

Stress in surgical educational environments: a systematic review.

Background: The effects of stress on surgical residents and how stress management training can prepare residents to effectively manage stressful situations is a relevant topic. This systematic review aimed to analyze the literature regarding (1) the current stress monitoring tools and their use in surgical environments, (2) the current methods in surgical stress management training, and (3) how stress affects surgical performance.

Methods: A search strategy was implemented to retrieve relevant articles from Web of Science, Scopus, and PubMed.

Simulation-based skills training: a qualitative interview study exploring surgical trainees' experience of stress.

Introduction: Stress can affect the ability to acquire technical skills. Simulation-based training (SBT) courses allow surgical trainees to train their technical skills away from stressful clinical environments. Trainees' subjective experiences of stress during SBT courses on laparoscopic surgery remains understudied.

Can effective pedagogy be ensured in minimally invasive surgery e-learning?

Introduction: Effectiveness of e-learning diminishes without the support of a pedagogical model to guide its use. In minimally invasive surgery (MIS), this has been reported as a limitation when technology is used to deliver contents without a sound pedagogical background.

Material And Methods: We describe how a generic pedagogical model, the 3D pedagogy framework, can be used for setting learning outcomes and activities in e-learning platforms focused on MIS cognitive skills.

Operators believe patient-specific rehearsal improve individual and team performance.

Introduction: Rehearsing endovascular aortic aneurysm repair on patient-specific data is recent within virtual reality simulation and opens up new possibilities for operators to prepare for complex procedures. This study evaluated the feasibility of patient-specific rehearsal (PsR) and assessed operators' appraisal of the VIST-LAB simulator from Mentice.

Material And Methods: CT-data was segmented and uploaded to the simulator, and simulated for 30 elective EVAR patients.

Use of pocket-sized ultrasound device in vascular surgery.

Background: Ultrasound is widely used in vascular surgery. Pocket-sized ultrasound devices have limited functionality compared to conventional ultrasound scanners, but are cheaper and highly portable. The aim of this study was to investigate whether vascular surgeons could benefit from using a pocket ultrasound device in everyday clinical practice.

Influence of patient-specific rehearsal on operative metrics and technical success for endovascular aneurysm repair.

Introduction: Patient-specific rehearsal (PsR) is a recent technology within virtual reality (VR) simulation that lets the operators train on patient-specific data in a simulated environment prior to the procedure. Endovascular aneurysm repair (EVAR) is a complex procedure where operative metrics and technical success might improve after PsR.

Material And Methods: We compared technical success and operative metrics (endovascular procedure time, contralateral gate cannulation time, fluoroscopy time, total radiation dose, number of angiograms and contrast medium use) between 30 patients, where the operators performed PsR (the PsR group), and 30 patients without PsR (the control group).

Construct validity of eoSim - a low-cost and portable laparoscopic simulator.

To examine the construct validity of the low-cost, portable laparoscopic simulator eoSim using motion analysis. Novice and experienced surgeons (≤ 100 and >100 laparoscopic procedures performed, respectively) completed four tasks on the eoSim using the SurgTrac software: intracorporeal suture and tie, tube ligation, peg capping and precision cutting. The following metrics were recorded: Time to complete task, distance traveled, handedness (left- versus right hand use), time off-screen, distance between instrument tips, speed, acceleration and motion smoothness.

Optimal timing of assessment tasks depending on experience level of surgical trainees.

Box trainers with motion analysis are important add-ons to surgical training and skills assessment outside the operating room, given that they exhibit construct validity. Four different tasks were tested for construct validity on a new laparoscopic box trainer with integrated motion analysis. Tracking data from the simulator were analyzed for eighteen parameters per task using an in-house software comparing participants with three different experience levels.

Psychomotor skills assessment by motion analysis in minimally invasive surgery on an animal organ.

Background: A high level of psychomotor skills is required to perform minimally invasive surgery (MIS) safely. To be able to measure these skills is important in the assessment of surgeons, as it enables constructive feedback during training. The aim of this study was to test the validity of an objective and automatic assessment method using motion analysis during a laparoscopic procedure on an animal organ.

Lack of transfer of skills after virtual reality simulator training with haptic feedback.

Background And Objective: Virtual reality (VR) simulators enrich surgical training and offer training possibilities outside of the operating room (OR). In this study, we created a criterion-based training program on a VR simulator with haptic feedback and tested it by comparing the performances of a simulator group against a control group.

Material And Methods: Medical students with no experience in laparoscopy were randomly assigned to a simulator group or a control group.

CustusX: an open-source research platform for image-guided therapy.

Purpose: CustusX is an image-guided therapy (IGT) research platform dedicated to intraoperative navigation and ultrasound imaging. In this paper, we present CustusX as a robust, accurate, and extensible platform with full access to data and algorithms and show examples of application in technological and clinical IGT research.

Methods: CustusX has been developed continuously for more than 15 years based on requirements from clinical and technological researchers within the framework of a well-defined software quality process.

Perceiving haptic feedback in virtual reality simulators.

Background: To improve patient safety, training of psychomotor laparoscopic skills is often done on virtual reality (VR) simulators outside the operating room. Haptic sensations have been found to influence psychomotor performance in laparoscopy. The emulation of haptic feedback is thus an important aspect of VR simulation.

Limitations of haptic feedback devices on construct validity of the LapSim® virtual reality simulator.

Background: Surgeons performing laparoscopy need a high degree of psychomotor skills, which can be trained and assessed on virtual reality (VR) simulators. VR simulators simulate the surgical environment and assess psychomotor skills according to predefined parameters. This study aimed to validate a proficiency-based training setup that consisted of two tasks with predefined threshold values and handles with haptic feedback on the LapSim(®) VR simulator.

A study of psychomotor skills in minimally invasive surgery: what differentiates expert and nonexpert performance.

Background: A high level of psychomotor skills is required to perform minimally invasive surgery (MIS) safely. To assure high quality of skills, it is important to be able to measure and assess these skills. For that, it is necessary to determine aspects that indicate the difference between performances at various levels of proficiency.

Procedural virtual reality simulation in minimally invasive surgery.

Background: Simulation of procedural tasks has the potential to bridge the gap between basic skills training outside the operating room (OR) and performance of complex surgical tasks in the OR. This paper provides an overview of procedural virtual reality (VR) simulation currently available on the market and presented in scientific literature for laparoscopy (LS), flexible gastrointestinal endoscopy (FGE), and endovascular surgery (EVS).

Methods: An online survey was sent to companies and research groups selling or developing procedural VR simulators, and a systematic search was done for scientific publications presenting or applying VR simulators to train or assess procedural skills in the PUBMED and SCOPUS databases.

Navigated laparoscopic ultrasound in abdominal soft tissue surgery: technological overview and perspectives.

Purpose: Two-dimensinal laparoscopic ultrasound (LUS) is commonly used for many laparoscopic procedures, but 3D LUS and navigation technology are not conventional tools in the clinic. Navigated LUS can help the user understand and interpret the ultrasound images in relation to the laparoscopic view and preoperative images. When combined with information from MRI or CT, navigated LUS has the potential to provide information about anatomic shifts during the procedure.

Laparoscopic ultrasound: a survey of its current and future use, requirements, and integration with navigation technology.

Background: Laparoscopic ultrasound (LUS) increases surgical safety by allowing the surgeon to see beyond the organ surface, by visualizing vascular structures and by improving surgical precision of tumor resection. A questionnaire-based survey was used to investigate the current use and future expectations of LUS technology.

Methods: A questionnaire consisting of 26 questions was distributed manually at four different conferences (60% at the European Association for Endoscopic Surgery (EAES) conference, Stockholm 2008).