Background: The “fulcrum effect” of the body wall on surgical instrument manipulation
is a major hurdle for novice endoscopic surgeons. Virtual reality training has not
previously been evaluated as a means to overcome this problem.
Materials and Methods: 16 participants with no experience of endoscopy were required
to make multiple defined incisions under laparoscopic laboratory conditions within
2-minute periods. Half of the subjects were randomized to receive initial training
on the Minimally Invasive Surgical Trainer, Virtual Reality (MIST VR) computer programme.
Results: Participants with MIST VR traing made significantly more correct incisions
(P = 0.0001) than the control group on test trial 1, and even after extended practice
by both groups (P = 0.0001). They were also significantly more likely to actively
use both hands to perform the endoscopic evaluation task (P = 0.01).
Conclusions: Virtual reality training represents a potential, viable solution for
junior endoscopists, for overcoming the “fulcrum effect”, in a replicable, safe learning
environment which allows objective and reliable quantification of skill levels by
trainers.
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Ph.D. A. G. Gallagher
School of Psychology
The Queen's University of Belfast
Belfast BT7 1NN
Northern Ireland
Telefon: + 44-232-664144
eMail: ag.gallagher@qub.ac.uk
