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Limitations of haptic feedback devices on construct validity of the LapSim® virtual reality simulator

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Abstract

Background

Surgeons performing laparoscopy need a high degree of psychomotor skills, which can be trained and assessed on virtual reality (VR) simulators. VR simulators simulate the surgical environment and assess psychomotor skills according to predefined parameters. This study aimed to validate a proficiency-based training setup that consisted of two tasks with predefined threshold values and handles with haptic feedback on the LapSim® VR simulator. The two tasks have been found to have construct validity in previous studies using handles without haptic feedback.

Methods

The participants were divided into three groups: novices (0–50 laparoscopic procedures), intermediates (51–300 laparoscopic procedures), and experts (more than 300 procedures). It was assumed that psychomotor skills increase with experience. All participants conducted the tasks lifting and grasping and fine dissection 20 times each. Validity of the training setup was investigated by comparing the number of times each participant passed a predefined threshold level for a set of 19 parameters.

Results

Construct validity was established for one parameter; “misses on right side” on the lifting and grasping task, whereas the other 18 parameters did not show construct validity.

Conclusion

The setup employed in this study failed to establish construct validity for more than one parameter. This indicates that the simulation of haptic feedback influences the training performance on laparoscopic simulators and is an important part of validating a training setup. A haptic device should generate haptic sensations in a realistic manner, without introducing frictional forces that are not inherent to laparoscopy.

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Abbreviations

VR:

Virtual reality

OR:

Operating room

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Acknowledgments

The National Centre for Advanced Laparoscopic Surgery, SINTEF, the National Centre for Ultrasound and Image-Guided Therapy, and the Norwegian University of Science and Technology (all Trondheim, Norway) have supported this work. We thank all those who participated in the study, in addition to Sébastien Müller for help with the statistics

Disclosures

Cecilie Våpenstad, Erlend Fagertun Hofstad, Lars Eirik Bø, Magdalena Karolina Chmarra, Esther Kuhry, Gjermund Johnsen, Ronald Mårvik, and Thomas Langø have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Medical Technology, SINTEF Technology and Society, PB 4760, Sluppen, 7465, Trondheim, Norway

    Cecilie Våpenstad, Erlend Fagertun Hofstad, Lars Eirik Bø & Thomas Langø

  2. Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway

    Lars Eirik Bø & Magdalena Karolina Chmarra

  3. Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway

    Esther Kuhry & Ronald Mårvik

  4. Department of Gastrointestinal Surgery and National Centre for Advanced Laparoscopic Surgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway

    Esther Kuhry, Gjermund Johnsen & Ronald Mårvik

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  1. Cecilie Våpenstad
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  2. Erlend Fagertun Hofstad
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  3. Lars Eirik Bø
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  8. Thomas Langø
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Correspondence to Cecilie Våpenstad.

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Våpenstad, C., Hofstad, E.F., Bø, L.E. et al. Limitations of haptic feedback devices on construct validity of the LapSim® virtual reality simulator. Surg Endosc 27, 1386–1396 (2013). https://doi.org/10.1007/s00464-012-2621-9

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