Education, Simulation & Virtual Reality

Moderated Poster Session

MP19-11 - The Validation of a New Laparoscopic Radical Nephrectomy Virtual Reality Module

Saturday, September 22
2:00 PM - 4:00 PM
Location: Room 241

Introduction & Objective :

Based on recent developments in surgical practice, working-hour restrictions, and ethical considerations, there is a growing need for integrated surgical training. Regarding the VR laparoscopic nephrectomy module, two previous studies generated conflicting results on construct validity (BJU Int. 2010, J Endourol. 2010). Our study aimed to validate a new VR laparoscopic nephrectomy module (Lap XⅡ™, MedVision, Japan).


Methods :

Experts (performed >50 laparoscopic surgeries), intermediates (performed 1-49), and novices (no experience) voluntarily included with the present study. After warm-up using basic VR modules and watching a demonstration movie prebuilt in the simulator, participants were required to perform laparoscopic left radical nephrectomy (transperitoneal approach) according to the guide of one author (TA). Questionnaires were collected after the training, in which a 5-point Likert scale was used by subjects to evaluate the simulator’s closeness to reality (5: very realistic, 3: average, 1: very poor), based on factors such as graphics, instrument handling, tissue resistance, and each step of nephrectomy, and data from the experts and intermediates were used for assessment of the content validity. Outcome parameters used in the present study were total time, blood loss, not suppressed bleeding, time of coagulation application, organ damage, and number of errors (combination of 24 different parameters).


Results :

Total 33 participants of 10 experts, 10 intermediates, and 13 novices performed this simulated module, and 26 participants finished the nephrectomy in the first trial, and 4 finished it in the second trial.  Because the remaining 3 participants could not finish the nephrectomy either in their first or second trial due to computer problems, their data were excluded from the study of construct validation. In terms of the closeness to reality, most of the aspects were rated as above average, except for tissue resistance, graphics of the pancreas, and those of the renal artery.  In terms of performance parameters, there were significant differences in blood loss (Kruskal-Wallis test, p=0.013), not suppressed bleeding (p=0.009), and number of errors (p=0.045) among the three groups. Those differences remained significant on excluding 4 participants who finished the nephrectomy on the second trial from the analyses.


Conclusions :

This study showed good content and construct validity for the Lap XⅡ™ nephrectomy module. It has the potential to become a part of the integrated laparoscopic training program.

Haruka Miyata

Clinical fellow
1. Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan

Haruka Miyata, MD
Title: The Validation of a New Laparoscopic Radical Nephrectomy Virtual Reality Module
Department of Renal and Genitourinary Surgery, Hokkaido University, Japan
Telephone: 81-11-716-1161
E-mail: harurun04192000@yahoo.co.jp

Education:
 MD: Hokkaido University School of Medicine, Sapporo, Japan :March 2011.
 National board in Japan: April 2011.
 Board of Japanese Urological Association: April 2013.
 Residency: Hokkaido University Hospital, Sapporo, Japan and the affiliated hospitals. (April 2011-present)
Board Certified Fellow of Japanese Urological Association: October 2017.

Memberships:
Japanese Urological Association


Personal:
Japanese Citizen
Unmarried
Excellent health

Current Position:
A graduate student of doctoral course of Hokkaido University . (April 2017-present)

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    Takashige Abe

    Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan

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      Madoka Higuchi

      clinical fellow
      1. Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan

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        Kiyohiko Hotta

        1. Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan

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          Kiyohiko Hotta

          1. Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan

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            Takahiro Osawa

            Assistant Professor
            1. Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan

            Hokkaido University hospital, department of urology, Sapporo, Hokkaido, Japan, 060-8638

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              Takahiro Osawa

              Assistant Professor
              1. Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan

              Hokkaido University hospital, department of urology, Sapporo, Hokkaido, Japan, 060-8638

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                Ryuji Matsumoto

                1. Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan

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                  Ryuji Matsumoto

                  1. Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan

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                    Hiroshi Kikuchi

                    1. Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan

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                      Hiroshi Kikuchi

                      1. Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan

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                        Yo Kurashima

                        2. Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Sapporo, Japan

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                          Yo Kurashima

                          2. Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Sapporo, Japan

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                            Sachiyo Murai

                            1. Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan

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                              Sachiyo Murai

                              1. Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan

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                                Nobuo Shinohara

                                Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan

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                                  Nobuo Shinohara

                                  Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan

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