AI Article Synopsis

  • The study developed and validated a scoring system (SALAS) to assess laparoscopic camera navigation (LCN) skills in medical students during virtual cholecystectomy.
  • A total of 84 students underwent training, with performance evaluated based on errors made and adjustments required as they assisted in surgery simulations.
  • Results indicated that higher LCN quality led to improved surgical performance, shorter operation times, and fewer errors, with gamers showing better outcomes.

Article Abstract

Introduction: To objectively assess the quality of laparoscopic camera navigation (LCN), the structured assessment of LCN skills (SALAS) score was developed and validated for laparoscopic cholecystectomy. The aim of this pre-clinical study was to investigate the influence of LCN on surgical performance during virtual cholecystectomy (vCHE) using this score.

Methods: A total of 84 medical students were included in this prospective study. Individual characteristics were assessed with questionnaires. Participants completed a structured 2-day training course on a validated virtual reality laparoscopic simulator. At the end of the course, all students took over LCN during vCHE, all performed by the same surgeon. The numbers of errors regarding centering, horizon adjustment and instrument visualisation as well as manual and verbal corrections by the surgeon were recorded to calculate the SALAS score (range 5-25) to investigate the influence of LCN on surgical performance. The study population was divided by the recorded SALAS score into low and medium performers (Group A; 1-3 quartile; n = 60) and high performers (Group B, 4 quartile, n = 21).

Results: The SALAS score of the camera assistant correlates positively with the surgeon's overall performance in vCHE (P < 0.001), and the surgeon's virtual laparoscopic performance was significantly better in Group B (P < 0.001). Moreover, a significantly shorter operation time during vCHE was shown for Group B (Median (IQR); Group A: 508 s [429 s; 601 s]; Group B: 422 s [365 s; 493 s]; P = 0.001). Frequent gaming and a higher self-confidence to assist during a basic laparoscopic procedure were associated with a higher SALAS score (P = 0.013).

Conclusion: In this pre-clinical setting, the surgeon's virtual performance is significantly influenced by the LCN quality. LCN by high performers resulted in a shorter operation time and a lower error rate.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7597869PMC
http://dx.doi.org/10.4103/jmas.JMAS_143_19DOI Listing

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