Virtual Operating Room Simulation Setup (VORSS) for Procedural Training in Minimally Invasive Surgery \u2013 a Pilot Study

Samir Ranjan Nayak,Meng Li,Sanne M B I Botden,Anne-Francoise Rutkowski,Sandeep Ganni,Jack Jakimowicz,Richard H M Goossens,Bhaskar Rao Ganni

doi:10.1007/s12262-020-02131-z

Abstract

Virtual reality (VR) training is widely used in several minimal invasive surgery (MIS) training curricula for procedural training. However, VR training in its current state lack immersive training environments, such as using head-mounted displays that is implemented in military or aviation training and even entertainment. The virtual operating room simulation setup (VORSS) is explored in this study to determine the effectiveness of immersive training in MIS. Twenty-eight surgeons and surgical trainees performed a laparoscopic cholecystectomy on the VORSS comprising of a head-mounted 360-degree realistic OR surrounding on a VR laparoscopic simulator. The VORSS replicated a full setup of instruments and surgical team-members as well as some of the distractions occurring during surgical procedures. Questionnaires were followed by semi-structured interviews to collect the data. Experts and novices found the VORSS to be intuitive and easy to use (p = 0.001). The outcome of the usability test, applying QUESI and NASA-TLX, reflected the usability of the VORSS (p < 0.05), at the cognitive level, which indicates a good sense of immersion and satisfaction, when performing the procedure within VORSS. The need for personalized experience within the setup was strongly noted from most of the participants. The VORSS for procedural training has the potential to become a useful tool to provide immersive training in MIS surgery. Further optimizing of the VORSS realism and introduction of distractors in the OR should result in an improvement of the system.

Highlights

Electronic supplementary material The online version of this article contains supplementary material, which is available to authorized users.Eindhoven, The Netherlands 4 Mechanical Engineering School, Xi’an Jiaotong University, Xi’an, People’s Republic of China 5 Department of Pediatric Surgery, Radboudumc – Amalia Children’sHospital, Nijmegen, the Netherlands 6 Department of Management, Tilburg University, Tilburg, The NetherlandsMinimally invasive surgery (MIS) is rapidly becoming the standard of treatment for many surgical pathologies. [1] the skills required to perform minimal invasive surgery (MIS) are significantly different to that of open surgery
[6] Several validation studies demonstrate the effective transfer of technical skills from the skills labs to the operating room (OR) with the use of procedural Virtual reality (VR) simulators. [7,8,9] a major deficiency of the current procedural VR simulation is its distraction-void and lack of immersive environments
[16] The responses were analyzed via Presence Questionnaire (PQ) [17], Questionnaire for Intuitive Use (QUESI) [18], NASA-Task Load Index (NASA-TLX) [19], and a heuristics questionnaire

Summary

Introduction

[7,8,9] a major deficiency of the current procedural VR simulation is its distraction-void and lack of immersive environments. Current VR simulators for MIS training are equipped with a monitor and instrument handles and foot pedals to perform procedure-specific tasks that replicate tissuespecific haptic feedback. They are set-up in isolated skills labs or rooms where they seldom replicate the busy and often chaotic operating room (OR) environment. Training in environments that replicate distractions increases the mental load and stress level of the surgeons and helps surgical trainees to adapt faster to the real OR environment. [11]

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