1568 A MULTI-INSTITUTIONAL RANDOMIZED CONTROLLED TRIAL OF AN AUGMENTED-REALITY BASED TECHNICAL SKILL ACQUISITION MODULE FOR ROBOT-ASSISTED URETHRO-VESICAL ANASTOMOSIS

摘要

You have accessJournal of UrologyTechnology & Instruments: Surgical Education & Skills Assessment (II)1 Apr 20131568 A MULTI-INSTITUTIONAL RANDOMIZED CONTROLLED TRIAL OF AN AUGMENTED-REALITY BASED TECHNICAL SKILL ACQUISITION MODULE FOR ROBOT-ASSISTED URETHRO-VESICAL ANASTOMOSIS Kamran Ahmed, Ashirwad Chowriappa, Rakeeba Din, Erinn Field, Yi Shi, Gregory Wilding, Anees Fazili, Dinesh Samarasekera, Jihad H. Kaouk, Jean Joseph, Ahmed Ghazi, Louis Eichel, Daniel Eun, James Peabody, James Mohler, Thenkurussi Kesavadas, and Khurshid Guru Kamran AhmedKamran Ahmed London, United Kingdom More articles by this author , Ashirwad ChowriappaAshirwad Chowriappa East Amherst, NY More articles by this author , Rakeeba DinRakeeba Din East Amherst, NY More articles by this author , Erinn FieldErinn Field East Amherst, NY More articles by this author , Yi ShiYi Shi Buffalo, NY More articles by this author , Gregory WildingGregory Wilding East Amherst, NY More articles by this author , Anees FaziliAnees Fazili Rochester, NY More articles by this author , Dinesh SamarasekeraDinesh Samarasekera Cleveland, OH More articles by this author , Jihad H. KaoukJihad H. Kaouk Cleveland, OH More articles by this author , Jean JosephJean Joseph Rochester, NY More articles by this author , Ahmed GhaziAhmed Ghazi Rochester, NY More articles by this author , Louis EichelLouis Eichel Rochester, NY More articles by this author , Daniel EunDaniel Eun Philadelphia, PA More articles by this author , James PeabodyJames Peabody Detroit, MI More articles by this author , James MohlerJames Mohler East Amherst, NY More articles by this author , Thenkurussi KesavadasThenkurussi Kesavadas Buffalo, NY More articles by this author , and Khurshid GuruKhurshid Guru East Amherst, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.3098AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To develop and validate a novel augmented reality based module for urethra-vesical anastomosis (UVA) during robot-assisted surgery utilizing the Hands on Surgical Training (HoST) Software. METHODS HoST integrates Augmented Reality (AR) and haptics to guide the trainee through real time operative steps in an immersive cognitive environment. This prospective, single-blinded randomized controlled trial allocated participants across three institutions to the HoST Group (HG) or the Control Group (CG). Da Vinci Surgical System (dVSS) was considered as the gold standard (for concurrent validity) and final evaluation to assess skills improvement after the educational interventions were made on the dVSS. After the initial video introduction of anastomosis, the CG performed the final UVA task using the dVSS. The HG performed HoST-based UVA module on the Robotic Surgical Simulator (RoSS) five times before performing the final UVA task on the dVSS. All tasks were video recorded. The outcome parameters were evaluation of feasibility, acceptability, face, concurrent validity and stress-level (NASA Task Load Index questionnaire of the AR UVA anastomosis model). Independent-blinded robotic surgeons (∼ 500 cases) evaluated the skills using validated 5 point task-specific scale and the 25 point Global Evaluation and Assessment of Robotic surgery Skills (GEARS) scale. RESULTS 22 surgeons (M 17; F 5) participated in the study. 71% found the HoST very close to the real surgical procedure (face validity). 82% felt the HoST to be an effective educational mode for learning procedural steps efficiently and safely. Significant differences in performance of Needle Driving (2.2 vs. 3.0; p 0.045) and Needle Positioning (2.2 vs. 2.8; p 0.033) was noted in the HG in comparison to CG when evaluated using task-specific scale. On the GEARS scale the HG obtained a significantly higher score in comparison to CG (14.4 vs. 10.5; p 0.012). Additionally, the NASA Load index test (stress-level evalua