Virtual Reality Single-Port Sleeve Gastrectomy Training Decreases Physical and Mental Workload in Novice Surgeons: An Exploratory Study
- 176 Downloads
Novice surgeons experience high levels of physical and mental workload during the early stages of their curriculum and clinical practice. Laparoscopic sleeve gastrectomy is the first bariatric procedure worldwide. Feasibility and safety of single-port sleeve gastrectomy (SPSG) has been demonstrated. An immersive virtual reality (VR) simulation was developed to provide a repetitive exercise to learn this novel technique. The primary objective of this study was to evaluate the impact of the VR training tool on mental and physical workload in novice surgeons. The secondary objective included an evaluation of the VR simulator.
A monocentric-controlled trial was conducted. Ten participants were divided into two groups, the VR group and the control group (without VR training). Surgery residents participated in a first real case of SPSG and a second case 1 month later. The VR group underwent a VR training between the two surgeries. Mental and physical loads were assessed with self-assessment questionnaires: NASA-TLX, Borg scale, and manikin discomfort test. The VR simulator was evaluated through presence, cybersickness, and usability questionnaires.
This study showed a decrease of the mental demand and effort dimensions of NASA-TLX between the first and the second surgery in the VR group (P < .05). During the second surgery, a marginally significant difference was shown concerning the mental demand between the two groups. Postural discomfort of the VR group decreased with practice (P < .01), mainly between the first and the second surgery (P < .05). Furthermore, participants characterized the VR simulator as realistic, usable, and very useful to learned surgery.
This exploratory study showed an improvement in mental and physical workload when novice surgeons trained with VR (repetitive practice, gesture improvement, reduction of stress, etc.). Virtual reality appears to be a promising perspective for surgical training.
KeywordsSingle port Sleeve Obesity Learning Simulation Virtual reality Human factors
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Ethical Approval Statement
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed Consent Statement
Informed consent was obtained from all individual participants included in the study.
- 8.García-Betances RI, Arredondo Waldmeyer MT, Fico G, et al. A succinct overview of virtual reality technology use in Alzheimer’s disease. Front Aging Neurosci. 2015 May;7(80):1–8.Google Scholar
- 19.Mantovani F, Castelnuovo G. The sense of presence in virtual training: enhancing skills acquisition and transfer of knowledge through learning experience in virtual environments. In: Riva G, Davide F, IJsselsteijn WA, editors. Being there: concepts, effects and measurement of user presence in synthetic environments. Amsterdam, Netherland: Ios Press; 2003. p. 168–81.Google Scholar
- 24.Brooke J. SUS-A quick and dirty usability scale. Usability evaluation in industry. 1996;189(194):4–7.Google Scholar
- 25.Azmandian M, Hancock M, Benko H, et al. Haptic retargeting: dynamic repurposing of passive haptics for enhanced virtual reality experiences. Proceedings of the CHI’16 conference on human factors in computing systems. 2016:1968–79.Google Scholar
- 26.Shewaga R, Uribe-Quevedo A, Kapralos B, et al. Comparison of seated and room-scale virtual reality in a serious game for epidural preparation. In: IEEE transactions on emerging topics in computing; 2017. p. 1–14.Google Scholar
- 27.Byers JC, Bittner AC, Hill SG. Traditional and raw task load index (TLX) correlations: are paired comparisons necessary? In: Mital A, editor. Advances in industrial ergonomics and safety. London: Taylor & Francis; 1989. p. 481–5.Google Scholar
- 28.Bouchard S, Robillard G, Renaud P, et al. Exploring new dimensions in the assessment of virtual reality induced side effects. J Comput Inf Technol. 2011;1(3):20–32.Google Scholar
- 29.Bangor A, Kortum P, Miller J. Determining what individual SUS scores mean: adding an adjective rating scale. J Usability Stud. 2009;4(3):114–23.Google Scholar
- 32.Chang TP, Gerard J, Pusic MV. Screen-based simulation, virtual reality, and haptic simulators. In: Grant VJ, Cheng A, editors. Comprehensive healthcare simulation: pediatrics: Springer; 2016. p. 105–14.Google Scholar