Comparative study to determine the proper sequence of simulation training, pelvic trainer versus virtual reality simulator: a pilot study

Abstract

Increased surgical efficacy has led to a remarkable increase in the usage of minimally invasive surgical procedures since their inception. The use of simulation in surgical teaching has grown significantly during the past 10 years. Several laparoscopic simulators have been built. Virtual reality (VR) simulators and box trainers (BTs), often known as pelvic trainers, are the two primary training modalities used in hospitals and clinical training institutes for the development and acquisition of laparoscopic skills. Our study aimed to evaluate the proper sequence of pelvic trainers and VR simulator training to improve laparoscopic gynecological skills. We carried out this pilot study at the Virtual Endoscopic Simulation and Skills Acquisition Laboratory at the Obstetrics and Gynecology Department in the Kasr Al Ainy Hospital, Faculty of Medicine, Cairo University, Egypt, from February to August 2022. All residents with minimal or without laparoscopic experience (twenty residents) were divided into two groups and classified as (group A versus group B). Group A’s training began with a pelvic trainer, which was tested using a checklist. Later, the group trained on a virtual reality simulator, which tested them using an electronic autoassessment. After training on a virtual reality simulator and passing an electronic autoassessment test, group B moved on to pelvic trainers and had a checklist-based assessment. We compared pelvic trainer tasks between the training groups, and detected no significant differences in camera navigation, cutting pattern, peg transfer, or running stitches (P values 0.646, 0.341, 0.179, and 0.939 respectively); when we compared VR simulator tasks between the training groups, there were no significant differences in camera navigation, cutting pattern, peg transfer, or running stitches (P values 0.79, 0.3, 0.33, and 0.06, respectively). There was no difference in training, between residents who started on a pelvic trainer or the VR simulator; therefore, both could be used in laparoscopic training with no preferred order. The trial was registered at clinicaltrials.gov with the name “Pelvic trainer vs VRS” and the identifier “NCT05255614.” The registration date was January 19, 2022, and the trial was prospectively registered. URL: https://register.clinicaltrials.gov/prs/app/action/ViewOrUnrelease?uid=U0004GED&ts=22&sid=S000BR5D&cx=t6mc14