Virtual reality training improves junior residents’ operating room performance: Results of a prospective, randomized, double-blinded study of the complete laparoscopic cholecystectomy

Abstract

Abstract Introduction: Previous studies evaluating the effect of virtual reality (VR) training on operating room performance have only analyzed the latter portion of the laparoscopic cholecystectomy (LC), while including many residents beyond their second year of training. The aim of this study was to better understand the impact of VR training on subjects with limited laparoscopic surgical experience during completion of an entire laparoscopic cholecystectomy. Methods: Twelve surgical residents (PGY 1 & 2) were randomized to either standard training (n = 6) or VR training (n = 6). In the VR training group subjects were required to reach expert established performance criterion levels on the manipulation diathermy task of the Minimally Invasive Surgical Trainer (MIST-VR). All subjects then performed a video-recorded LC under the supervision of a surgeon blinded to training status. Recordings were assessed by two blinded surgeon investigators using scores based on expert-defined errors with inter-rater reliability >0.9. Results: VR trained subjects completed the full LC 20% faster than controls (39 min. vs. 31 min.), made half as many errors while exposing cystic structures (5.3 vs 10), and one-third fewer errors in dissecting the gallbladder (5.5 vs. 8.2). Overall, controls made 40% more errors (11.7 vs 19.7, p Conclusions: Criterion based VR training to expert performance levels for junior surgical residents results in fewer intra-operative errors and greater performance consistency during the entire laparoscopic cholecystectomy procedure.