292 Augmented Reality: A Novel Approach T­­o Surgical Simulation, a Objective & Subjective Validation, Health Economics Study & Systematic Review

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Abstract Aim To validate the novel LapAR for surgical simulation. Method Utilising a high-fidelity simulator (LapAR1), we validated efficacy alongside health economics evaluation with an appropriate systematic review analysing the various styles of training. Results A pilot benchmarked two appendicectomies or vaginal cuffs with two rounds of intervening LapPass2. One hour on the simulator found ‘time’ savings of 19% and 36.9%, and ‘distance(m)’ savings of 25% and 56.5% respectively. A multi-centre has shown that 10 appendectomy benchmarks, with three LapPass rounds in two weeks can reduce ‘time’ by 55-66% and ‘distance’ by 39-72%. All figures are statistically significant following multiple-regression analyses. Self-confidence scores on a day course indicated that all areas improved by a mean of 3.82 (likert, p = 0.018). A BMJ peer-reviewed health economics review4 was then performed using estimated costs. The potential Return on Investment (ROI) for the NHS was deduced. At 100% translation rate alongside validation data, we save £455 per patient through reduced anaesthetic time and shorter inpatient stay. Finally, a SR (n = 26) of literature on the main four (AR vs VR vs traditional vs cadaveric) demonstrated that AR is preferred, improves procedural success & provides faster skill acquisition. Conclusions Reduced complication rates, anaesthetic time and ability to reduce waiting list burden would form future scopes of study. However, we can now infer that AR-based laparoscopic training with the LapAR is not only preferred, but it is more effective at providing clinically translatable, and scalable cost-effective laparoscopic training as a potential new gold standard.