An Indigenous Virtual Reality-Based Simulator-a Tool in Surgical Training

Virtual reality (VR) surgical simulation is the latest addendum to the surgical skills laboratory, and it makes inferences about levels of surgical performance by measuring motion, efficiency, errors and time taken to perform a task. The high costs associated with acquiring these simulators have limited the universal availability of such trainers across institutions in our country. This study aims to validate an indigenously designed Indian virtual reality simulation-based trainer as a valuable tool in surgical training. The performance parameters of ten laparoscopic basic surgical skill tasks were analysed. These included deviation from the desired path (error), total distance traversed in performing the task (distance in mm) and total time taken to complete the task (task completion time in seconds). One hundred seventy tasks performed by novices and 100 by experts were included for comparative analyses. Significant difference was found with regard to distance traversed by instruments (p value < 0.001) and total time for completion of a task (p value < 0.001) both of which were lesser in the group of tasks performed by experts. The distance traversed by instruments were higher amongst novices compared with experts. The task completion time was higher amongst novices in all the exercise except that of peritoneal layer peeling. These virtual reality-based simulators are a valid tool in surgical training that offer a wide range of exercises comparable to conventional trainers. These trainers analyse performance of the user as well as distinguish their level of expertise. This quality provides the added benefit of objective feedback of performance, thereby enabling a trainee to progress towards becoming a highly skilled laparoscopic surgeon.