内視鏡外科手術の教育におけるバーチャルリアリティ手術シミュレータの役割

Abstract

Objective : This study aimed to evaluate the impact of virtual reality (VR) surgical simulator training on improvement of individual skills for endoscopic surgery and to consider its role in the training system. Methods : (1) Forty-one subjects were assigned to one of the three groups : experienced surgeons experiencing >50 endoscopic procedures (n=12), inexperienced surgeons (1～30 endoscopic procedures, n=9), and medical students with no prior experience (n=20). The participants were trained with LapSim® simulator, and their skills were evaluated with LapSim® “Cutting” task before and after the training. (2) Twenty subjects received training for endoscopic suturing using two types of VR simulator and a training box. After the training, they were asked to select the best training modality. Results : (1) Significant improvements in laparoscopic skills were observed in all three groups after the training. The significant differences in surgical skills observed between each group diminished following the training. (2) Most (15/20) subjects chose the box training as the best training method due to its authenticity. Conclusions : VR simulator is useful in the acquisition of psychomotor skills, but not sufficient for training the suturing technique. The role of VR simulator, currently limited in the training of endoscopic surgery, is expected to expand pending future progress of VR technology.