Creating a Proficiency-Based Virtual Reality Simulation Training Programme for Laparoscopic Assisted Colectomy (LAC)
Creating and Implementing a Proficiency-Based Progression Virtual Reality Training Programme for Higher Surgical Trainees for Laparoscopic Assisted Sigmoid Colectomy.
Laparoscopic Colectomy is an advanced minimally invasive procedure that requires advanced laparoscopic skills.
Minimally invasive surgery offers many advantages to the patients but exposes the surgeon to new challenges, many of which are human factor in nature. This in turn prolongs the learning curve and has delayed the widespread adoption of minimally invasive surgical techniques in the management of patients with colorectal disease.
Virtual reality simulation offers an effective way of training whereby surgical trainees can train repeatedly and achieve proficiency in a shorter time and a safe environment.
연구 개요
상태
정황
상세 설명
Introduction:
Minimally Invasive Surgery (MIS) has conferred considerable advantages on patient's post operative outcome and recovery when compared with open surgery.
Major clinical trials including; Clinical Outcomes of Surgical Therapy Study Group (COSTSG), Colon Cancer Laparoscopic or Open Resection (COLOR), and Conventional vs. Laparoscopic-Assisted Surgery in Colorectal Cancer (CLASICC) have uniformly and consistently shown a significant reduction in the post operative pain, the use of narcotics and oral analgesics, and length of hospital stay, as well as a faster resumption of diet, return of bowel function when using a MIS approach.
Despite all these advantages to the patients, MIS imposed a significant difficulty on the surgeons. These difficulties were primarily human factor in nature.
The use of Virtual Reality (VR) simulation has been proven to help in the acquisition of MIS skills. The use of proficiency-based, virtual reality simulation should help training of MIS providers in a safe environment where complex tasks can be repeated as many times as needed to achieve a pre-set proficiency level. A well designed proficiency-based simulation curriculum should help the widespread use of the MIS approach.
Aims
Primary:
We aim to prove that subjects randomised to train under a proficiency-based progression simulation curriculum (SC) will learn to perform laparoscopic assisted colectomy faster, complete more surgical steps and commit fewer operative errors compared to subjects randomised to the current surgical training curriculum (CC)
Secondary:
We aim to set the institutional and national proficiency level for Laparoscopic Assisted Colectomy (LAC) using the ProMIS-LAC simulator from Haptica, Ireland.
Methods Randomised, controlled, single blinded, multicentre study. Primary Variable 8 centres, 8 co-investigators (expert consultant laparoscopic colorectal surgeons > 300 MIS procedures) and 16 surgical trainees will be recruited for the study. Subjects (surgical trainees) will be randomised into;
- Simulator Curriculum (SC) group.
- Conventional Curriculum (CC) group.
Subjects randomised to the CC group will continue to have the conventional training programme offered at their respective hospitals. Subjects randomised to the SC group will complete a standardised laparoscopic skills training course followed by a training curriculum including the performance of simulated LAC procedures in nine predetermined steps on the simulator. Subjects must reach a predetermined proficiency level to complete the simulation training course before re-joining their training programme offered at their respective hospitals. .
Upon completion of the training courses, both groups' subject populations will perform a total of five LAC procedures on consecutive patients in the presence of a surgeon proctor.
Patients indicated for LAC procedure will be screened, consented, and enrolled as patients into this study. Each procedure will be recorded and forwarded to the chief investigator for analysis. The number of completed surgical steps and the incidence of intraoperative errors between the two SC and CC groups will be evaluated via blinded video review.
Secondary Variable
All participating co-investigators will participate in defining the proficiency level for LAC on the ProMIS-LAC simulator.
The average values of the recorded metrics which are obtained from the expert performance will be used to set the proficiency level.
연구 유형
등록 (예상)
단계
- 해당 없음
연락처 및 위치
연구 장소
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Cork, 아일랜드
- 모병
- Mercy University Hospital
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연락하다:
- Michael O'Riordain, MD, FRCS
- 전화번호: +353 21 4935336
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부수사관:
- Michael O'Riordain, MD, FRCSI
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Dublin, 아일랜드, 24
- 모병
- AMNCH
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연락하다:
- Dairmuid O'Riordain, MD, FRCSI
- 전화번호: +353 1 414 2213
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부수사관:
- Dairmuid O'Riordain, MD, FRCSI
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Dublin, 아일랜드, 4
- 모병
- St. Vincent'S University Hospital
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연락하다:
- Desmond Winter, MD, FRCSI
- 전화번호: +353 1 2214000
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부수사관:
- Desmond Winter, MD, FRCSI
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Dublin, 아일랜드, 9
- 모병
- Beaumont Hospital
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연락하다:
- Deborah McNamara, MD, FRCSI
- 전화번호: +353 1 8093000
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부수사관:
- Deborah McNamara, MD, FRCSI
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Dublin, 아일랜드, Co. Dublin
- 모병
- AMNCH
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연락하다:
- Paul Neary, MD, FRCSI
- 전화번호: +35314142000
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수석 연구원:
- Paul Neary, MD, FRCSI
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Tullamore, 아일랜드, Co Offaly
- 모병
- Tullamore general hospital
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연락하다:
- Dermot Hehir, FRCSI
- 전화번호: +35357 93 22206
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부수사관:
- Dermot Hehir, FRCSI
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Antrim, 영국
- 모병
- Antrim Area Hospital
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연락하다:
- Colman Byrnes, MD, FRCS
- 전화번호: +44 028 9442 4000
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부수사관:
- Colman Byrnes, Md, FRCS
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Glasgow, 영국
- 모병
- Gartnavel General Hospital
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연락하다:
- Richard Molloy, MD, FRCS
- 전화번호: +44 1412113483
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부수사관:
- Richard Molloy, MD, FRCS
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Leicester, 영국
- 모병
- Leicester Royal Infirmary Hospital
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연락하다:
- Andrew Miller, MD, FRCS
- 전화번호: +44 116 2586853
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부수사관:
- Andrew Miller, MD, FRCS
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Newcastle, 영국
- 모병
- Freeman Hospital
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연락하다:
- Alan Horgan, MD, FRCS
- 전화번호: +44 191 2137420
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부수사관:
- Alan Horgan, MD, FRCS
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참여기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
설명
Inclusion criteria for subjects
- Classified as year 3-5 post graduation registrars, specialist registrars or residents in surgery.
- Completed their Basic Surgical Training programme.
- Completed at least 12 months period on a Higher Surgical Training programme.
- In an accredited surgical post at time of participation
- In a colorectal surgery rotation at time of participation
- Signed their own consent form
Exclusion criteria for subjects
- Performed, as primary surgeon, > 10 advanced laparoscopic procedures (laparoscopic cholecystectomy, inguinal hernia, appendectomy, Nissen fundoplication, or ventral incisional hernia repair are not considered advanced laparoscopic procedures )
- Performed, as primary surgeon, laparoscopic assisted colectomy procedures
- Performed, as primary surgeon, any hand-assisted laparoscopic colectomy procedures
- Did not sign their own consent form
Inclusion criteria for patients
- Indicated for a laparoscopic assisted sigmoid colectomy or high anterior resection
- At least 18 years old upon date of signing the informed consent document (ICD)
- Sign their own ICD
Exclusion criteria for patients
- History or current diagnosis of synchronous colon cancer
- Indicated for urgent surgery
- Indicated for diverting stoma
- American Society of Anaesthesiologists (ASA) Classification of Physical Status IV-V
- Tumour classified as T4
- An obstructed colon
- Planned early conversion based on findings at operative visualisation.
- Pregnancy
- < 18 years of age
- Mental disability
- Did not sign their own ICD
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 하나의
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
|---|---|
|
실험적: SC
Subjects (surgical trainees) randomised to train under a proficiency-based progression virtual reality simulation curriculum
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Subjects (surgical trainees) will be trained under a proficiency-based virtual reality simulation training programme before performing their first live case
다른 이름들:
|
|
활성 비교기: CC
Subjects (surgical trainees) randomised to the current surgical training curriculum
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Subjects (surgical trainees) will continue to train under the current training methodology offered at their institution before they perform their first live case.
다른 이름들:
|
연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
기간 |
|---|---|
|
Subjects randomised to train under a proficiency-based simulation curriculum (SC) will perform laparoscopic assisted colectomy faster, complete more surgical steps and commit fewer operative errors compared to subjects randomised to the control group
기간: 6-12 months
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6-12 months
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2차 결과 측정
결과 측정 |
기간 |
|---|---|
|
We aim to set the institutional and national proficiency level for Laparoscopic Assisted Colectomy (LAC) using the ProMIS-LAC simulator from Haptica, Ireland.
기간: 30 days
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30 days
|
공동 작업자 및 조사자
수사관
- 수석 연구원: Paul Neary, MD, FRCSI, Royal College of Surgeons in Ireland
간행물 및 유용한 링크
일반 간행물
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연구 기록 날짜
연구 주요 날짜
연구 시작
기본 완료 (예상)
연구 완료 (예상)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (추정)
연구 기록 업데이트
마지막 업데이트 게시됨 (추정)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
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