7643 Use of Augmented Reality Training to Improve Laparoscopic Vaginal Vault Closure Metrics

Abstract

<h3>Study Objective</h3> To assess the impact of Augmented Reality Training on improving Laparoscopic Vaginal Vault Closure using objective performance metrics. <h3>Design</h3> Utilising the LapAR by Inovus Medical Ltd (UK), we asked Obstetrics and Gynecology trainees to perform several Augmented Reality simulated vaginal-vault closures interspersed with LapPass (UK equivalent of FLS) tasks. Objective metrics measured includes: time to completion, distance travelled, smoothness, acceleration, handedness and time in view. Comparison was made with a benchmark score set by an experienced MIGS surgeon. Subjective performance feedback was also provided by experienced MIGS surgeons using the OSATS framework. <h3>Setting</h3> Within an NHS (National Health Service) University Teaching hospital in South London. <h3>Patients or Participants</h3> Obstetrics and Gynecology junior trainees (SHO's and registrars) - US equivalent of residents and fellows. <h3>Interventions</h3> During the course, benchmarks of both LapPass tasks and Vaginal Vault closures were set by each trainee in addition to an experienced MIGS surgeon. Trainees were then asked to perform a series of tasks including further Vaginal Vault closures and LapPass tasks. Following this period of intervention, trainees were set one final benchmark to compare to their original. <h3>Measurements and Main Results</h3> We found that the performance metrics improved when comparing initial & final benchmarks. In addition, the final benchmark metrics of the trainees were compared in a standardisation exercise to the benchmark set by the experienced MIGS surgeon. Of note, time to completion and distance travelled were both markedly reduced following the intervention period. OSAT based review of performance demonstrated a marked improvement in surgical skill. <h3>Conclusion</h3> Augmented Reality task training using a high-fidelity Laparoscopic box trainer such as the LapAR improves objective and subjective performance in vaginal vault closure. It can be inferred that this technique improves the surgical learning curve whilst safely taking it away from the live patient.