WTP6.10 A validation & health economics review of a novel Augmented Reality solution to surgical training

Abstract

Abstract Aims To validate the capability of AR in surgical training utilising objective & subjective assessment, health economics & systematic review (SR) of available literature. Methods & Results Initially an independent SR was conducted (n=26) comparing AR vs incumbent modalities (VR, box trainers, & cadaveric). We demonstrated that AR is preferred, improves procedural success & provides faster skill acquisition when compared to other modalities. Several pilot studies were then conducted utilising the LapAR1. One (n=11) demonstrated through benchmarks of either appendicectomies (n=5) or vaginal vault (n=6) closures that intervening AR-based training under one hour with LapPass2 tasks significantly improved ‘completion time’ by 19% and 36.9%, and ‘distance travelled(m)’ by 25% and 56% respectively. Another (n=6) demonstrated through 10 appendicectomy benchmarks with three intervening LapPass tasks over the course of two weeks, significant savings in ‘completion time’ by 55-66% and ‘distance travelled’ by 39-72%. Finally, another study looking at self-confidence scores pre & post-LapAR exercises indicated that a mean improvement of 3.82 (likert, p=0.018) was found across all areas. Finally, a BMJ peer-reviewed health economics review3 found that £79 could be saved per appendicectomy patient. Once validation of the efficiency assumptions were made using the study data, we can extrapolate and realise a potential cost saving of £455 through reduced anaesthetic time and shorter inpatient stay. Conclusions We can now infer that AR-based laparoscopic training with the LapAR is not only preferred, but it is more effective at providing clinically translatable, and scalable cost-effective laparoscopic training as a potential new gold standard.