Virtual Reality Simulation in Teaching Fetoscopic Laser Placental Photocoagulation in Twin-To-Twin Transfusion
Catherine Windrim1,2, Colin Charleson3, David Rojas Gualdron2
1Ontario Fetal Centre, Department of Obstetrics and Gynaecology, Mount Sinai Hospital, Toronto, Canada.
Objective:
To develop and validate a novel virtual reality (VR) simulation system for training fetoscopic laser placental photocoagulation in twin-to-twin transfusion syndrome (TTTS).
Methods:
A VR-based simulator incorporating Meta Quest headsets and custom-designed hardware was developed. The system features realistic anatomical modeling, integrated performance metrics, and progressive training modules. Validation involved 31 participants (11 experienced fetal therapy specialists, 10 fetal therapy fellows, and 10 other maternal-fetal medicine specialists) who evaluated the simulator across five domains using a standardized questionnaire.
Results:
The simulator demonstrated excellent internal consistency (Cronbach's α = 0.92) with strong positive validation across all measured aspects. Training effectiveness received the highest endorsement (87%, 95% CI: 83%-91%), followed by user engagement (85%, 95% CI: 81%-89%). Experienced specialists rated environmental realism significantly higher (4.8 ± 0.3, p = 0.002), while fellows provided the strongest endorsement for training effectiveness (4.8 ± 0.3, p = 0.004).
Conclusions:
This VR simulator represents a significant advancement in TTTS surgical education, offering comprehensive training capabilities without requiring practice on actual patients. Initial testing demonstrates feasibility for both local and remote teaching applications, with potential advantages in cost, portability, and educational capabilities compared to traditional physical simulators.
