Simulation speeds up adaptation to the 3D exoscope: a randomized controlled trial.

Area of Science:

• Surgical Simulation
• Medical Education Technology
• Minimally Invasive Surgery

Background:

• Exoscopes offer an alternative to traditional operative microscopes for intraoperative visualization.
• Transitioning to exoscope use requires novel skill acquisition.
• Currently, no virtual simulators exist for exoscope-specific surgical training.

Purpose of the Study:

• To develop a virtual exoscope simulator.
• To evaluate if brief simulator training improves exoscope control and microsurgical task performance in novices.

Main Methods:

• Forty novice medical students were randomized into a control group or a simulator training group.
• The training group received 45 minutes of exoscope control simulator training.
• Both groups performed a standardized microsurgical task using a 3D exoscope, assessing camera control and manual dexterity.

Main Results:

• The simulator training group exhibited significantly faster disc transitions (median 4min 26s vs. 5min 17s) and disc entries (median 4min 8s vs. 8min 1s).
• Both groups showed improvement across trials, with a moderate effect size (Cohen's d=0.56).
• No significant differences were observed in exoscope movements or needle drop frequency between groups.

Conclusions:

• Brief virtual exoscope simulator training effectively enhances novice adaptation to exoscope controls.
• Simulator training positively impacts manual microsurgical task performance in inexperienced individuals.
• Further research is warranted to assess the impact on experienced surgeons, particularly neurosurgeons.