Using a dynamic training environment to acquire laparoscopic surgery skill

Current physical laparoscopic surgical simulators provide training only for static tasks, which do not develop the more advanced hand-eye coordination skills needed to navigate the dynamic surgical environment. A novel dynamic minimally invasive training environment (DynaMITE) was developed to address this need. This study aimed to evaluate further the utility of the system as a training and skill assessment tool. Two studies were performed with a second-generation design. The authors hypothesized that the dynamic task environment would be challenging to novices and would differentiate experienced surgeons from the inexperienced by emphasising the dynamic skills gained through surgical experience.

The participants in the first study were 42 novice and experienced surgeons attending the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) 2007 Learning Center, whereas the second controlled laboratory study had 16 participants (5 novices and 11 experienced surgeons). The participants performed two tasks: an aiming task and an object manipulation task. Both tasks were positioned on a dynamic platform that moved in five different trajectories.

The subjective feedback from the surgeons at the SAGES Learning Center was positive. The results from the controlled study showed significant performance deterioration in the fast diagonal task compared with the task of aiming and manipulating in the static environment for both experience groups but no performance differences between the groups.

Dynamic tasks are challenging, and surgeons need to be trained specifically for these tasks. The DynaMITE system can provide training benefits for dynamic skill development, even for expert surgeons who may have had no opportunity to gain these skills through their surgical practice.