Validity Assessment of the Laparoscopic Radical Nephrectomy Module of the LapVision® Virtual Reality Simulator

Abstract

Background: Virtual reality (VR) simulators allow trainees to perform repeated practice, and provide objective dexterity metrics regarding their performance, which means that VR-based surgical training is becoming a vital part in initial learning of basic laparoscopic surgical skills. However, its educational role of learning advanced procedures remains undetermined. We evaluated the validity of the laparoscopic radicalnephrectomy module of the LapVision® virtual reality simulator. Methods: Urologists, medical students, and junior resident voluntarily participated in the present study and they performed a laparoscopic left radical nephrectomy module. For construct validation, dexterity metrics calculated in the simulator, and mean score of Global Operative Assessment of Laparoscopic Skills (GOALS) evaluated by two experts’ video review were compared according to the certification of Japanese Endoscopic Surgical Skill Qualification (ESSQ) or previous surgical experience. Results: Ten experts (>50 laparoscopic surgeries), 9 intermediates (11-49), and 14 novices (0-10) voluntarily joined the present study. Regarding the construct validity, there was a significant difference in the total number of errors, blood loss, and GOALS score among the groups for both the ESSQ status and previous surgical experience. Conclusions: The present study demonstrated good construct validity for the LapVision® nephrectomy module. Furthermore, global skill assessment could be possible by experts’ reviews, which means the usefulness of VR procedural module for skill assessment tool. VR-based procedural simulation has marked potential to become a vital part of integrated laparoscopic training programs.