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Endovascular Repair of Ruptured Abdominal Aortic Aneurysm: Technical and Team Training in an Immersive Virtual Reality Environment

  • Clinical Investigation
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Abstract

Purpose

This study evaluates a fully immersive simulated angiosuite for training and assessment of technical endovascular and human factor skills during a crisis scenario.

Materials and Methods

Virtual reality (VIST-C, Mentice) simulators were integrated into a simulated angiosuite (ORCAMP, Orzone). Teams, lead by experienced (N = 5) or trainee (N = 5) endovascular specialists, performed simulated endovascular ruptured aortic aneurysm repair (rEVAR). Timed performance metrics were recorded as surrogate measures of performance. Participants (N = 22) completed postprocedure questionnaires evaluating face validity, as well as technical and human factor aspects, of the simulation on a Likert scale from 1 (not at all) to 5 (very much).

Results

Experienced team leaders were significantly faster than trainees in obtaining proximal control with an intra-aortic occlusion balloon (352 vs. 501 s, p = 0.047) and all completed the procedure within the allotted time, whilst no trainee was able to do so. Total fluoroscopy times were significantly lower in the experienced group (782 vs. 1,086 s, p = 0.016). Realism of the simulated angiosuite was scored highly by experienced team leaders (median 4/5, IQR 4–5). Participants found the simulation useful for acquiring technical (4/5, IQR 4–5) and communication skills (4/5, IQR 4–5) and particularly valuable for enhancing teamwork (5/5, IQR 4–5) and patient safety (5/5, IQR 4–5).

Conclusion

This study shows feasibility of creation of a crisis scenario in a fully immersive angiosuite simulation and team performance of a simulated rEVAR. Performance metrics differentiated between experienced specialists and trainees, and the realism of the simulation exercise and environment were rated highly by experienced endovascular specialists. This simulation has potential as a powerful training and assessment tool with opportunities to improve team performance in rEVAR through both technical and human factor skills training.

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Acknowledgments

We acknowledge with thanks the participants and faculty on the Imperial College Vascular Interventional Radiology Virtual Reality Simulation Course 2012, Mentice (Gothenburg, Sweden) for providing VR simulators and technical support and Orzone (Gothenburg, Sweden) for providing technical support. This research was funded by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Imperial College Healthcare National Health Service (NHS) Trust and Imperial College London. The views expressed are those of the authors and not necessarily those of the NHS, NIHR or the Department of Health.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Surgery and Cancer, St Mary’s Hospital, Imperial College London, 10th Floor QEQM, South Wharf Road, 1003, London, W2 1NY, UK

    Nung Rudarakanchana, Isabelle Van Herzeele, Colin D. Bicknell, Celia V. Riga, Alexander Rolls, Nicholas J. W. Cheshire & Mohamad S. Hamady

  2. Imperial Vascular Unit, Imperial Healthcare NHS Trust, London, UK

    Nung Rudarakanchana, Colin D. Bicknell, Celia V. Riga, Alexander Rolls & Nicholas J. W. Cheshire

  3. Department of Thoracic and Vascular Surgery, Ghent University Hospital, Ghent, Belgium

    Isabelle Van Herzeele

  4. Department of Interventional Radiology, Imperial Healthcare NHS Trust, London, UK

    Mohamad S. Hamady

Authors
  1. Nung Rudarakanchana
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  2. Isabelle Van Herzeele
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  3. Colin D. Bicknell
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  4. Celia V. Riga
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  5. Alexander Rolls
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  6. Nicholas J. W. Cheshire
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  7. Mohamad S. Hamady
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Corresponding author

Correspondence to Mohamad S. Hamady.

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Rudarakanchana, N., Van Herzeele, I., Bicknell, C.D. et al. Endovascular Repair of Ruptured Abdominal Aortic Aneurysm: Technical and Team Training in an Immersive Virtual Reality Environment. Cardiovasc Intervent Radiol 37, 920–927 (2014). https://doi.org/10.1007/s00270-013-0765-1

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  • DOI: https://doi.org/10.1007/s00270-013-0765-1

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