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ViewAttendees 2

Session: New Technology Abstract Session (NON CME)

NT2 - Virtual Reality Straight Coloanal Anastomosis Simulator Automatically Differentiates Between Expert and Novice Users

Monday, June 3, 2024
4:23 PM – 4:26 PM ET, USA
Location: Room 314-317

    Abstract Podium Presenter(s)

  • Alexis Desir, MD

    General Surgery Resident
    UT Southwestern
    Dallas, TX, United States

    All relevant financial disclosures have been managed and will be listed below.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • GW

    George Westergaard, BS

    Doctoral Candidate
    Florida Polytech University
    Lakeland, Florida, United States

    Disclosure information not submitted.

  • LF

    Lucas Fair, MD

    General Surgery Resident
    Baylor University Medical Center
    Dallas, Texas, United States

    Disclosure information not submitted.

  • Fernando Lambreton, MD

    Colorectal Surgery Fellow
    Baylor University Medical Center
    Dallas, TX, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • PP

    Poya Pourghaderi, DO

    Colorectal fellow
    Univeristy of Texas Southwestern
    Dallas, TX, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • DD

    Doga Demirel, PhD

    Doctoral Faculty
    Florida Polytechnic University
    Lakeland, Florida, United States

    Disclosure information not submitted.

  • JS

    Javier Salgado Pogacnik, MD

    Section Chief of Colorectal Surgery
    University of Texas Southwestern Medical Center
    Dallas, Texas, United States

    Disclosure information not submitted.

  • SD

    Suvranu De, Sc. D.

    Dean, Professor of Mechanical Engineering
    Florida A&M University-Florida State University College of Engineering
    Tallahassee, Florida, United States

    Disclosure information not submitted.

  • GS

    Ganesh Sankaranarayanan, PhD

    Associate Professor and Co-director of the Center for Assessment of Surgical Proficiency
    University of Texas Southwestern Medical Center
    Dallas, Texas, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • James W. Fleshman, MD, FACS, FASCRS

    Department Chair of Surgery
    Baylor University Medical Center
    Texas A&M College of Medicine
    Plano, TX, United States

    Disclosure information not submitted.

Purpose/Background: The straight coloanal anastomosis (SCA) procedure performed using an end-to-end anastomosis (EEA) circular stapler is an essential technical skill in colorectal surgery and is part of the Colorectal Structured Objective Assessment of Technical Skills (COSATS). As part of an NIH-funded project, we are developing a virtual reality (VR) simulator for training and assessment for all the open surgical tasks of the COSATS. For the SCA task, we have developed an immersive virtual simulator with task-specific automated assessment of performance. The objective of this work is to assess the discriminant validity of our virtual SCA simulator.

Methods/Interventions: The immersive VR simulator consists of a model of colon and anus. Each participant performed a purse string suture to secure the anvil and then created the anastomosis using a virtual Covidien EEA circular stapler (Figure 1). Two Geomagic Touch haptic devices were used to control motion and provided haptic feedback. Buttons on the stylus were used to control the firing of the stapler and perform a leak test. An Oculus Quest Head Mounted Display (HMD) was used for immersion. In this IRB approved study, novice (PGY3-5) and expert (Fellow and Attending) participants performed the task on the simulator at the UT Southwestern Medical Center and Baylor Scott & White Dallas. Five validated metrics (suture handling, complete deployment of central trocar/spike, full closure of the stapler, safe extraction of the stapler, and anastomosis verification) were used for automated monitoring of participant performance. A one-tailed t-test was used to assess the difference between the groups.

Results/Outcomes: A total of 16 participants performed the task of which (n = 9) were novices and (n = 7) were experts. Overall, experts performed significantly better than novices on the simulator (Total score: 42.12 vs 38.33, t = -3.12, p = 0.004), demonstrating discriminant validity (Figure 2).

Conclusion/Discussion: Our VR SCA simulator with automated assessment of performance has satisfactory discriminant validity. Our simulator can be used for training and feedback in this procedure, avoiding the costs and risks of using an actual stapler. Our next step is to assess the usefulness of our simulator in training and transfer of skills to the actual procedure in the operating room.