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Zabaleta J, Blasco A, Esnal T, Aguinagalde B, López IJ, Fernandez-Monge A, Lizarbe JA, Báez J, Aldazabal J. Clinical trial on nurse training through virtual reality simulation of an operating room: assessing satisfaction and outcomes. Cir Esp 2024:S2173-5077(24)00117-0. [PMID: 38762218 DOI: 10.1016/j.cireng.2024.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/12/2024] [Indexed: 05/20/2024]
Abstract
INTRODUCTION Virtual reality (VR) provides a firsthand active learning experience through varying degrees of immersion. The aim of this study is to evaluate the use of VR as a potential tool for training operating room nurses to perform thoracic surgery procedures. METHODS This is an open parallel-group randomized clinical trial. One group received basic formation followed by an assessment module. The experimental group received the same basic formation, followed by thoracic surgery training and an assessment module. RESULTS Fifty-six nurses participated in the study (51 females), with a mean age of 41.6 years. Participants achieved a median evaluation mode score of 480 points (IQR = 32 points). The experimental group (520 points) achieved an overall higher score than the control group (440 points; P = .04). Regarding age, women in the second quartile of age among the participants (35-41 years) achieved significantly better results than the rest (P = .04). When we evaluated the results based on the moment of practice, exercises performed in the last 10 minutes obtained better results than those performed in the first 10 minutes (1064 points versus 554 points; P < .001). Regarding adverse effects blurred vision was the most frequent. The overall satisfaction rating with the experience was 8.5 out of 10. CONCLUSION Virtual reality is a useful tool for training operating room nurses. Clinical trial with ISRCTN16864726 registered number.
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Affiliation(s)
- Jon Zabaleta
- Department of Thoracic Surgery, Basque Health Service, Donostialdea Integrated Health Organisation, San Sebastian, Spain.
| | - Amaya Blasco
- Department of Thoracic Surgery, Basque Health Service, Donostialdea Integrated Health Organisation, San Sebastian, Spain
| | | | - Borja Aguinagalde
- Department of Thoracic Surgery, Basque Health Service, Donostialdea Integrated Health Organisation, San Sebastian, Spain
| | - Iker J López
- Department of Thoracic Surgery, Basque Health Service, Donostialdea Integrated Health Organisation, San Sebastian, Spain
| | - Arantza Fernandez-Monge
- Department of Thoracic Surgery, Basque Health Service, Donostialdea Integrated Health Organisation, San Sebastian, Spain
| | - Jon A Lizarbe
- Department of Thoracic Surgery, Basque Health Service, Donostialdea Integrated Health Organisation, San Sebastian, Spain
| | - Jaime Báez
- Tecnun, School of engineering, University of Navarra, San Sebastian, Spain
| | - Javier Aldazabal
- Tecnun, School of engineering, University of Navarra, San Sebastian, Spain
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Bracale U, Iacone B, Tedesco A, Gargiulo A, Di Nuzzo MM, Sannino D, Tramontano S, Corcione F. The use of mixed reality in the preoperative planning of colorectal surgery: Preliminary experience with a narrative review. Cir Esp 2024:S2173-5077(24)00037-1. [PMID: 38307256 DOI: 10.1016/j.cireng.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/14/2024] [Indexed: 02/04/2024]
Abstract
New advanced technologies have recently been developed and preliminarily applied to surgery, including virtual reality (VR), augmented reality (AR) and mixed reality (MR). We retrospectively review all colorectal cases in which we used holographic 3D reconstruction from February 2020 to December 2022. This innovative approach was used to identify vascular anomalies, pinpoint tumor locations, evaluate infiltration into neighboring organs and devise surgical plans for both training and educating trainee assistants. We have also provided a state-of-the-art analysis, briefly highlighting what has been stated by the scientific literature to date. VR facilitates training and anatomical assessments, while AR enhances training and laparoscopic performance evaluations. MR, powered by HoloLens, enriches anatomic recognition, navigation, and visualization. Successful implementation was observed in 10 colorectal cancer cases, showcasing the effectiveness of MR in improving preoperative planning and its intraoperative application. This technology holds significant promise for advancing colorectal surgery by elevating safety and reliability standards.
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Affiliation(s)
- Umberto Bracale
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Salerno, Italy
| | - Biancamaria Iacone
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy.
| | - Anna Tedesco
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy
| | - Antonio Gargiulo
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy
| | | | - Daniele Sannino
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy
| | - Salvatore Tramontano
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84084 Salerno, Italy
| | - Francesco Corcione
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy
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Gil Piquer R, Mañes Jiménez Y, España Marí M, Peris Peris A, Solanes Donet P, García Lledó N, Pons Fernández N. Usefulness of virtual reality in the management of pain associated with venepuncture: a multicentre randomized clinical trial. An Pediatr (Barc) 2024; 100:25-33. [PMID: 38158270 DOI: 10.1016/j.anpede.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/19/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVE To assess the efficacy of virtual reality (VR) in reducing pain and anxiety associated with scheduled blood draws. MATERIAL AND METHODS We conducted multicentre randomized clinical trial in both primary care and hospital settings. The study included children aged 7-12 years undergoing blood extraction procedures between March and October 2022. The intervention group used headsets, and the control group received usual care. Pain was assessed using the visual analogue scale and anxiety using the Groningen Distress Scale. The anxiety of the nursing staff and family satisfaction were assessed with numerical scales ranging from 1 to 10. RESULTS The study included 83 patients: 40 in the control group and 43 in the VR group. The median age was 10 years (range, 7-12 years). In the VR group, 83.7% of the children reported mild pain, compared to 57.5% in the control group (P = .012). Also, 93% of children in the VR group showed calm or mild anxiety (score, 1-2), compared to 72% of the control group, a difference that was not statistically significant (P = .08). Family satisfaction was higher in the RV group (score ≥ 9/10: 93% of RV group vs 72.5% of control group; P = .026). The nursing staff anxiety score was less than 5 in more than 90% of cases, with no differences between groups (P = .13). CONCLUSION The use of VR during venepuncture decreases the pain perceived by children and increases the satisfaction of their families.
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Affiliation(s)
- Raquel Gil Piquer
- Servicio de Pediatría, Hospital Lluís Alcanyís, Xàtiva, Valencia, Spain.
| | | | - María España Marí
- Servicio de Pediatría, Hospital Lluís Alcanyís, Xàtiva, Valencia, Spain
| | - Anna Peris Peris
- Servicio de Pediatría, Hospital Lluís Alcanyís, Xàtiva, Valencia, Spain
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Vidal-Sicart S, Goñi E, Cebrecos I, Rioja ME, Perissinotti A, Sampol C, Vidal O, Saavedra-Pérez D, Ferrer A, Martí C, Ferrer Rebolleda J, García Velloso MJ, Orozco-Cortés J, Díaz-Feijóo B, Niñerola-Baizán A, Valdés Olmos RA. Continuous innovation in precision radio-guided surgery. Rev Esp Med Nucl Imagen Mol 2024; 43:39-54. [PMID: 37963516 DOI: 10.1016/j.remnie.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 10/26/2023] [Indexed: 11/16/2023]
Abstract
Since its origins, nuclear medicine has faced technological changes that led to modifying operating modes and adapting protocols. In the field of radioguided surgery, the incorporation of preoperative scintigraphic imaging and intraoperative detection with the gamma probe provided a definitive boost to sentinel lymph node biopsy to become a standard procedure for melanoma and breast cancer. The various technological innovations and consequent adaptation of protocols come together in the coexistence of the disruptive and the gradual. As obvious examples we have the introduction of SPECT/CT in the preoperative field and Drop-in probes in the intraoperative field. Other innovative aspects with possible application in radio-guided surgery are based on the application of artificial intelligence, navigation and telecare.
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Affiliation(s)
- Sergi Vidal-Sicart
- Servicio de Medicina Nuclear, Hospital Clínic Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
| | - Elena Goñi
- Servicio de Medicina Nuclear, Hospital Universitario de Navarra, Pamplona, Spain
| | - Isaac Cebrecos
- Instituto Clínic de Ginecología, Obstetricia y Neonatología (ICGON), Hospital Clínic Barcelona, Barcelona, Spain
| | | | - Andrés Perissinotti
- Servicio de Medicina Nuclear, Hospital Clínic Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), ISCIII, Madrid, Spain
| | - Catalina Sampol
- Servicio de Medicina Nuclear, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Oscar Vidal
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Cirugía General y Digestiva, ICMDiM, Hospital Clínic de Barcelona, Barcelona, Spain; Departamento de Cirugía, Universitat de Barcelona, Barcelona, Spain
| | - David Saavedra-Pérez
- Cirugía General y Digestiva, ICMDiM, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Ada Ferrer
- Servicio de Cirugía Maxilofacial, Hospital Clínic Barcelona, Barcelona, Spain
| | - Carles Martí
- Servicio de Cirugía Maxilofacial, Hospital Clínic Barcelona, Barcelona, Spain
| | - José Ferrer Rebolleda
- Servicio Medicina Nuclear Ascires, Hospital General Universitario de Valencia, Valencia, Spain
| | | | - Jhon Orozco-Cortés
- Servicio de Medicina Nuclear, Hospital Clínico Universitario de Valencia, Barcelona, Spain
| | - Berta Díaz-Feijóo
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Instituto Clínic de Ginecología, Obstetricia y Neonatología (ICGON), Hospital Clínic Barcelona, Barcelona, Spain; Departamento de Cirugía, Universitat de Barcelona, Barcelona, Spain
| | - Aida Niñerola-Baizán
- Servicio de Medicina Nuclear, Hospital Clínic Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), ISCIII, Madrid, Spain; Departamento de Biomedicina, Facultad de Medicina, Universitat de Barcelona, Barcelona, Spain
| | - Renato Alfredo Valdés Olmos
- Department of Radiology, Section of Nuclear Medicine & Interventional Molecular Imaging Laboratory, Leiden University Medical Center, Leiden, The Netherlands
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Matwala K, Shakir T, Bhan C, Chand M. The surgical metaverse. Cir Esp 2023:S2173-5077(23)00229-6. [PMID: 37984726 DOI: 10.1016/j.cireng.2023.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 10/14/2023] [Indexed: 11/22/2023]
Abstract
Recent developments have seen acceleration in the development of virtual reality (VR) and augmented reality (AR) technology. Through these developments, the metaverse has emerged. Within the metaverse, users create an avatar to experience an immersive, interactive extended reality. Current front-runners in its implementation are the financial, communication and entertainment sectors. This technology, however, is receiving greater recognition in the medical world, with national and international surgical bodies acknowledging the benefits that VR and the metaverse will have on surgical training and patient care. Its versatility means that we are likely to see VR related technology become intimately woven into the fabric of surgery in the next two decade. In this article, the impact of the metaverse on the surgical field will be discussed.
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Affiliation(s)
| | - Taner Shakir
- University College London Hospital, United Kingdom.
| | - Chetan Bhan
- University College London Hospital, United Kingdom
| | - Manish Chand
- University College London Hospital, United Kingdom
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Martí-Hereu L, Navarra-Ventura G, Navas-Pérez AM, Férnandez-Gonzalo S, Pérez-López F, de Haro-López C, Gomà-Fernández G. Usage of immersive virtual reality as a relaxation method in an intensive care unit. Enferm Intensiva (Engl Ed) 2023:S2529-9840(23)00048-4. [PMID: 37648599 DOI: 10.1016/j.enfie.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 04/19/2023] [Accepted: 05/04/2023] [Indexed: 09/01/2023]
Abstract
INTRODUCTION The usage of immersive virtual reality (iVR) in the context of an intensive care unit (ICU) is scarce. Our objective was to assess the feasibility of the usage of iVR in critical patients with or without mechanical ventilation (MV) and to determine the anxiety degree before and after each session. METHODS Analytical, descriptive, prospective, and cross-sectional research. Pilot test with 20 patients from a polyvalent ICU of a tertiary hospital. Adult patients were included, either connected or not to MV, watchful and calmed (RASS -1/+1) and without delirium (negative CAM-ICU). Oculus Go (Facebook Technologies, LLC) iVR glasses were the model used. The relaxation strategy consisted in the visualization of an experience of 15 min with scenes related to nature and fantasy, relaxing music with a plot. The sessions were individual, with the patient monitored in a fowler position or seated. The anxiety degree before and after each session was evaluated following a reduced version of the Spanish "Cuestionario de Ansiedad Estado-Rasgo (STAI-e)" and they were analysed using T samples coupled (statistical significance when p-value was <0.05). RESULTS Incorporation of 20 patients with an average age of 63.9 years old (60% men). A total of 34 sessions of iVR were conducted. 32% patients mechanically ventilated, 32% high-flow oxygen therapy, 36% other breathing supports. 80% of the sessions were completed without serious side effects. A significant decrease in the anxiety degree was observed after each iVR session: first session mean change -2.68 (SD = 2.75), p = 0.000; second session mean change -1.86 (SD = 1.57), p = 0.021; third session mean change -1.67 (SD = 1.63), p = 0.054. CONCLUSION The usage of iVR in the context of an ICU is feasible, even with patients mechanically ventilated. iVR reduces the anxiety degree in the critic patient, which suggests that "digital therapies" can be effective to improve the emotional state during their stay in the ICU.
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Affiliation(s)
- L Martí-Hereu
- Área de Críticos, Consorcio Corporación Sanitaria Parc Taulí, Sabadell, Barcelona, Spain.
| | | | - A M Navas-Pérez
- Área de Críticos, Consorcio Corporación Sanitaria Parc Taulí, Sabadell, Barcelona, Spain
| | | | - F Pérez-López
- Área de Metodología, Consorcio Corporación Sanitaria Parc Taulí, Sabadell, Barcelona, Spain
| | - C de Haro-López
- Área de Críticos, Consorcio Corporación Sanitaria Parc Taulí, Sabadell, Barcelona, Spain
| | - G Gomà-Fernández
- Área de Críticos, Consorcio Corporación Sanitaria Parc Taulí, I3PT, Fundación Parc Taulí, Sabadell, Barcelona, Spain
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Fernández-González D, Rodriguez-Costa I, Sanz-Esteban I, Estrada-Barranco C. Therapeutic intervention with virtual reality in patients with Parkinson's disease for upper limb motor training: A systematic review. Rehabilitacion (Madr) 2023; 57:100751. [PMID: 36344299 DOI: 10.1016/j.rh.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 06/05/2022] [Accepted: 06/06/2022] [Indexed: 11/06/2022]
Abstract
To analyze the scientific evidence regarding changes in upper extremities in patients with Parkinson's disease who use virtual reality as part of their neurological rehabilitation treatment. The search was carried out in the following databases: MEDLINE, Cochrane Library, PEDROs and SCOPUS. The following inclusion criteria were applied to a total of 106 articles: Randomized clinical trials with an age of 5 years, the sample had to be of patients with PD (regardless of their state of involvement) and who had performed RV in the treatment of limbs superiors. A total of n=7 articles were used, in which the variables corresponding to upper limb motor control were measured, such as: fine motor dexterity, gross motor dexterity, strength, tremor, functionality and speed. Virtual Reality as tool in neurorehabilitation in patients with Parkinson's disease shows positive effects in all measurements related to upper limb motor control.
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Affiliation(s)
| | - I Rodriguez-Costa
- Humanization in the Intervention of Physiotherapy for the Integral Attention to the People (HIPATIA) Research Group, Physiotherapy Department, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - I Sanz-Esteban
- Universidad Europea de Madrid, Faculty of Sport Sciences, Department of Physiotherapy, Villaviciosa de Odón, Madrid, Spain
| | - C Estrada-Barranco
- Universidad Europea de Madrid, Faculty of Sport Sciences, Department of Physiotherapy, Villaviciosa de Odón, Madrid, Spain.
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Pérez Baena AV, Sendra Portero F. The objective structured clinical examination (OSCE): Main aspects and the role of imaging. Radiologia (Engl Ed) 2023; 65:55-65. [PMID: 36842786 DOI: 10.1016/j.rxeng.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 09/28/2022] [Indexed: 02/28/2023]
Abstract
The objective structured clinical examination (OSCE) is a format of examination that enables students to be evaluated in a uniform, standardized, reliable, and objective way. It is carried out in different clinical stations that simulate real clinical situations and scenarios. Numerous universities in Spain and other countries employ this approach for the final examination for medical school students. This update describes the organization, design, and fundamentals for the OSCE, proposing that radiology should form part of multidisciplinary OSCEs to the extent that it forms part of clinical practice. Moreover, it is interesting and opportune to introduce the OSCE in undergraduate and postgraduate training in radiology. Online platforms enable bidimensional OSCEs that are cost-effective in terms of staff, resources, and physical space, although this approach has certain limitations. Virtual world technologies make it possible to reproduce OSCE stations in three-dimensional scenarios; recent experiences in radiology have shown that this approach interests and motivates students and is widely accepted by them.
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Affiliation(s)
- A V Pérez Baena
- Servicio de Radiodiagnóstico, Hospital Comarcal de Antequera, Antequera, Spain.
| | - F Sendra Portero
- Departamento de Radiología y Medicina Física, Facultad de Medicina, Málaga, Spain
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Meneses Castaño C, Penagos P, Yamile Jaramillo B. [Effectiveness of robotic technology and virtual reality for the rehabilitation of motor function in cerebral palsy. Systematic review]. Rehabilitacion (Madr) 2022:S0048-7120(22)00079-2. [PMID: 36344300 DOI: 10.1016/j.rh.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/06/2022] [Accepted: 07/10/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Cerebral palsy (CP) is a health condition secondary to non-progressive damage that occurs during brain development in the fetal or infant stage. To evaluate the effectiveness of robotic technology and virtual reality on motor function in patients with CP compared to conventional rehabilitation strategies such as physical therapy, occupational therapy, neurodevelopmental intervention, and transcranial stimulation. A review of randomized controlled trials of the last 5 years was carried out. For the evaluation of the methodological quality of the included studies, the PEDro scale was used, with evaluation of the level of evidence and degree of recommendation according to the Oxford classification. RESULTS Seventeen articles met the eligibility criteria. Robotic technology and virtual reality proved to be effective in improving motor function, manual skills, and visual-perceptual skills in patients with CP, compared to the use of conventional rehabilitation strategies.
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Affiliation(s)
- C Meneses Castaño
- Escuela Colombiana de Rehabilitación, Bogotá, Cundinamarca, Colombia.
| | - P Penagos
- Escuela Colombiana de Rehabilitación, Bogotá, Cundinamarca, Colombia
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de Los Reyes-Guzmán A, Fernández García L, Alvarez-Rodríguez M, Lozano-Berrio V, Domingo-García AM, Ceruelo-Abajo S. [Low-cost virtual reality. A new application for upper extremity motor rehabilitation in neurological pathology: Pilot study]. Rehabilitacion (Madr) 2022; 56:173-181. [PMID: 34511255 DOI: 10.1016/j.rh.2021.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 06/25/2021] [Accepted: 07/08/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVES The aim of this study is to present a new virtual reality (VR) low cost application based on Leap Motion Controller (LMC) device for upper extremity motor rehabilitation after neurological pathology and to demonstrate its clinical feasibility by carrying out a pilot experience. MATERIAL AND METHODS The LMC allows the interaction with virtual applications by capturing the patient's hand movements. A pilot study was carried out with 4 patients with upper limb impairment reflected with Upper Extremity Motor Score (UEMS) greater than 10. They were assessed using the Box and Block (BBT) and the writing task within the Jebsen-Taylor Hand Function (JTHF) before and after the intervention. RESULTS All patients completed the 9-session, 30-min protocol divided into 3 sessions per week. They went from an average result of 38 (SD 20) blocks in BBT before the intervention to 44 (SD 21.72) after it. They went from 28.25 s (SD 8.61) to 26.75 s (SD 21.72) in the JTHF. Statistically significant differences were no found. The device usability was assessed by the QUEST scale, being the security, effectiveness and ease to use the aspects that patients considered to be a priority. CONCLUSIóN: A new VR development based on the LMC device is presented and the clinical feasibility of its application in neurological patients with upper limb involvement has been proven. A clinical study with a large sample size is needed to assess its potential clinical effectiveness as a treatment element.
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Affiliation(s)
| | - L Fernández García
- Servicio de Rehabilitación. Complejo Hospitalario Universitario de Toledo, Toledo, España
| | - M Alvarez-Rodríguez
- Unidad de Biomecánica. Hospital Nacional de Parapléjicos de Toledo, Toledo, España
| | - V Lozano-Berrio
- Unidad de Biomecánica. Hospital Nacional de Parapléjicos de Toledo, Toledo, España
| | - A M Domingo-García
- Unidad de Terapia Ocupacional. Hospital Nacional de Parapléjicos de Toledo, Toledo, España
| | - S Ceruelo-Abajo
- Servicio de Rehabilitación. Hospital Nacional de Parapléjicos de Toledo, Toledo, España
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Alañón Fernández FJ, Alañón Fernández M, Alañón Cárdenas F, Marín González B, Cueva-López V. Improvements in planning lacrimal surgery using DICOM Horos® viewer 3D images. Arch Soc Esp Oftalmol (Engl Ed) 2021; 96:509-514. [PMID: 34620480 DOI: 10.1016/j.oftale.2020.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 12/14/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION AND OBJECTIVE The individual anatomic variation of the course of the lacrimal duct and surrounding structures requires the thorough knowledge of its three-dimensional configuration in order to perform the surgery in the safest and most efficient way. The aim of this study was to consider virtual surgical planning in order to improve dacryocystorhinostomies. METHODS Horos® was used as a viewer and manager of DICOM-format images for multiplanar, three-dimensional (3D) reconstruction when planning 148 first-time lacrimal operations and 26 reoperations by laser endonasal and endocanalicular DCRs. RESULTS The 3D images of the CT dacryocystography were much better identified than the 2D ones, Horos® showing a statistically significant correlation (P < .0001). Over 98.27% of the images match the programme reconstruction. Less than 1.73% of them showed some discordance due to study distortion. These cases were related to trauma. The intraopearative location of the lacrimal system was very accurate, avoiding complications. CONCLUSIONS Viewing and studying 3D images, Horos® is a very useful tool for diagnosis and preoperative planning. It is very helpful in complex conditions by marking surgical references, locating the lacrimal sac and controlling the post-operative permeability of the lacrimal system. The information loss produced by the image selection is also avoided. Another great advantage is that the programme is free.
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Alañón Fernández FJ, Alañón Fernández M, Alañón Cárdenas F, Marín González B, Cueva-López V. Improvements in planning lacrimal surgery using DICOM Horos® viewer 3D images. Arch Soc Esp Oftalmol (Engl Ed) 2021; 96:S0365-6691(21)00012-5. [PMID: 33653582 DOI: 10.1016/j.oftal.2020.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 12/05/2020] [Accepted: 12/14/2020] [Indexed: 11/18/2022]
Abstract
INTRODUCTION AND OBJECTIVE The individual anatomic variation of the course of the lacrimal duct and surrounding structures requires the thorough knowledge of its three-dimensional configuration in order to perform the surgery in the safest and most efficient way. The aim of this study was to consider virtual surgical planning in order to improve dacryocystorhinostomies. METHODS Horos® was used as a viewer and manager of DICOM-format images for multiplanar, three-dimensional (3D) reconstruction when planning 148 first-time lacrimal operations and 26 reoperations by laser endonasal and endocanalicular DCRs. RESULTS The 3D images of the CT dacryocystography were much better identified than the 2D ones, Horos® showing a statistically significant correlation (P<.0001). Over 98.27% of the images match the programme reconstruction. Less than 1.73% of them showed some discordance due to study distortion. These cases were related to trauma. The intraopearative location of the lacrimal system was very accurate, avoiding complications. CONCLUSIONS Viewing and studying 3D images, Horos® is a very useful tool for diagnosis and preoperative planning. It is very helpful in complex conditions by marking surgical references, locating the lacrimal sac and controlling the post-operative permeability of the lacrimal system. The information loss produced by the image selection is also avoided. Another great advantage is that the programme is free.
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Rodríguez-D'Jesús A, Uchima H. 360° video recording inside a GI endoscopy room: Technical feasibility and its potential use for the acquisition of gastrointestinal endoscopy skills. Pilot experience. Gastroenterol Hepatol 2021; 44:245-9. [PMID: 32829959 DOI: 10.1016/j.gastrohep.2020.04.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 04/17/2020] [Accepted: 04/30/2020] [Indexed: 11/24/2022]
Abstract
New advances in video processing, 3-dimensional designs, and augmented/virtual reality are exciting and evolving fields. These new tools can facilitate the learning phase of basic or advanced endoscopic procedures. Herein, we explain our initial experience, creating an immersive virtual reality (IVR) by using 360-degree recording videos from an interventional endoscopy room. Some common terms used around this technology, such as Augmented reality (AR), Virtual Reality (VR), Three hundred sixty videos, and Mixed Reality (MR), are discussed below. Three examples of VR 360 endoscopic room videos are included in this article.
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Munsamy AJ, Paruk H, Gopichunder B, Luggya A, Majola T, Khulu S. The effect of gaming on accommodative and vergence facilities after exposure to virtual reality head-mounted display. J Optom 2020; 13:163-170. [PMID: 32234359 PMCID: PMC7301196 DOI: 10.1016/j.optom.2020.02.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 01/21/2020] [Accepted: 02/09/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND To investigate the change between accommodative and vergence facilities before and after exposure to gaming in a virtual reality (VR) device amongst participants with normal binocular visual function. METHODS 62 participants between the ages of 18-30 years with normal binocular visual function and inter-pupillary distances between 51 and 70 mm were selected for the study. Spectacle and contact lenses users were excluded. The experimental group (n = 42) was exposed to gaming using Samsung Gear VR(SM -R323) whilst the control group (n = 20) watched a television film projected on a two-dimensional screen at 1 m. Pre-test and post-test binocular amplitude-scaled facilities and vergence facilities were obtained for both groups after exposures of 25 min. RESULTS Binocular accommodative facilities for the experimental group had a mean pre-test and post-test facility of 11.14 ± 3.67 cpm and 13.38 ± 3.63 cpm, respectively, after gaming using VR device. The vergence facilities for the experimental group had a mean pre-test and post-test facility of 11.41 ± 3.86 cpm and 15.28 ± 4.93 cpm, respectively, after gaming using a VR device. Binocular accommodative facilities for the control group had a mean pre-test and post-test facility of 11.70 ± 3.2 cpm and 11.95 ± 3.4 cpm, respectively. Vergence facilities for the control group had a mean pre-test and post-test facility of 11.55 ± 6.4 cpm and 11.70 ± 4.9 cpm, respectively. The mean change for binocular accommodative facilities was 2.24 ± 3.43 cpm and 0.25 ± 1.25 cpm for the experimental and control group, respectively. The mean change for vergence facilities was 3.81 ± 3.09 cpm and 0.15 ± 2.72 cpm for the experimental and control group, respectively. Binocular accommodative facilities and vergence facility showed a statistically significant mean increase greater than the control group after gaming using a VR device using an independent t-test (p < 0.05). CONCLUSION The results showed that binocular accommodative facilities and vergence facilities increased after 25 min of VR gaming in emmetropic participants under 30 years of age with inter-pupillary distances between 51 mm and 70 mm.
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Affiliation(s)
- Alvin J Munsamy
- Discipline of Optometry, School of Health Science, University of KwaZulu-Natal, Westville Campus, Durban, South Africa.
| | - Husna Paruk
- Discipline of Optometry, School of Health Science, University of KwaZulu-Natal, Westville Campus, Durban, South Africa
| | - Bronwyn Gopichunder
- Discipline of Optometry, School of Health Science, University of KwaZulu-Natal, Westville Campus, Durban, South Africa
| | - Anela Luggya
- Discipline of Optometry, School of Health Science, University of KwaZulu-Natal, Westville Campus, Durban, South Africa
| | - Thembekile Majola
- Discipline of Optometry, School of Health Science, University of KwaZulu-Natal, Westville Campus, Durban, South Africa
| | - Sneliswa Khulu
- Discipline of Optometry, School of Health Science, University of KwaZulu-Natal, Westville Campus, Durban, South Africa
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Del Pozo Jiménez G, Rodríguez Monsalve M, Carballido Rodríguez J, Castillón Vela I. Virtual reality and intracorporeal navigation in urology. ARCH ESP UROL 2019; 72:867-881. [PMID: 31579046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To provide an overview of the meaning and types of virtual reality (VR) system, its current applications in the field of urology and future implications. SYNTHESIS OF THE EVIDENCE The concept of VR involves the generation of computer environments with which a user can interact directly. Urology technologies and surgical practices are constantly evolving and RV simulation has become an important complement in urologist training curricula, taking into account not only simulations in surgical techniques, but also in non-surgical techniques such as communication and decision making. VR approaches for image-guided surgery have demonstrated potential in the field of urology by supporting guidance for various disorders. An increasing number of pre and intraoperative imaging modalities have been used to create detailed surgical route maps. The tracing of these surgical roadmaps with the surgical vision of real life has been produced in different ways (electromagnetic, acoustic, optical ...), recommending the combination of several approaches to provide a superior result. One of the disadvantages of navigation systems is soft tissue deformations, requiring confirmatory images. Although early studies report that navigation surgeries provide results equal to or greater than conventional approaches, most of the work has been done in relatively small groups of patients, thus requiring studies with larger sample sizes. CONCLUSIONS The development of VR offers urologists many opportunities, with surgical simulation being one of its most important applications today. Likewise, the first clinical studies have demonstrated the potential of augmented reality (2D and 3D models) to improve surgical accuracy, describing different navigation systems for different urological surgical interventions.
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Affiliation(s)
- Gema Del Pozo Jiménez
- Servicio de Urología. Hospital Universitario Puerta de Hierro de Majadahonda. Madrid. España
| | | | | | - Ignacio Castillón Vela
- Servicio de Urología. Hospital Universitario Puerta de Hierro de Majadahonda. Madrid. España
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Cerezo Espinosa C, Segura Melgarejo F, Melendreras Ruiz R, García-Collado ÁJ, Nieto Caballero S, Juguera Rodríguez L, Pardo Ríos S, García Torrano S, Linares Stutz E, Pardo Ríos M. Virtual reality in cardiopulmonary resuscitation training: a randomized trial. Emergencias 2019; 31:43-46. [PMID: 30656873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVES To assess the efficacy of virtual reality (VR) in cardiopulmonary resuscitation (CPR) training. MATERIAL AND METHODS Experimental, analytic, cross-sectional study of a CPR training method using VR. Participants were randomly assigned to train in a control group or a VR group. RESULTS The mean (SD) scores on a scale of 10 after training were 9.28 (0.91) in the VR group and 7.78 (1.63) in the control group, for a mean difference of 1.49 (95% CI, 0.96-2.02; P<.001). The VR group achieved a mean of 97.5 (9.7) compressions/min, versus 80.9 (7.7) compressions/min in the control group, for a mean difference of 16.6 compressions/min (95% CI, 15.0-18.2; P=.003). The mean compression depth in the VR group was 34.0 (6.5) mm, versus 27.9 (4.9) mm in the control group, for a mean difference of 6.7 (95% CI, 5.7-7.8; P<.001). CONCLUSION Training with VR can improve CPR theoretical knowledge and practical skills.
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Affiliation(s)
- Cristina Cerezo Espinosa
- Programa Doctorado en Ciencias de la Salud, Universidad Católica de Murcia (UCAM), España. Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | | | | | | | - Sergio Nieto Caballero
- Programa Doctorado en Ciencias de la Salud, Universidad Católica de Murcia (UCAM), España. Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España. Gerencia de Urgencias y Emergencias Sanitarias 061 de la Región de Murcia, España
| | | | - Sergio Pardo Ríos
- Conserjería de Educación y Universidades de la Región de Murcia, España
| | | | | | - Manuel Pardo Ríos
- Gerencia de Urgencias y Emergencias Sanitarias 061 de la Región de Murcia, España
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Pujol J, Ondategui-Parra JC, Badiella L, Otero C, Vilaseca M, Aldaba M. Spherical subjective refraction with a novel 3D virtual reality based system. J Optom 2017; 10:43-51. [PMID: 26856962 PMCID: PMC5219830 DOI: 10.1016/j.optom.2015.12.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 09/18/2015] [Accepted: 12/14/2015] [Indexed: 06/05/2023]
Abstract
PURPOSE To conduct a clinical validation of a virtual reality-based experimental system that is able to assess the spherical subjective refraction simplifying the methodology of ocular refraction. METHODS For the agreement assessment, spherical refraction measurements were obtained from 104 eyes of 52 subjects using three different methods: subjectively with the experimental prototype (Subj.E) and the classical subjective refraction (Subj.C); and objectively with the WAM-5500 autorefractor (WAM). To evaluate precision (intra- and inter-observer variability) of each refractive tool independently, 26 eyes were measured in four occasions. RESULTS With regard to agreement, the mean difference (±SD) for the spherical equivalent (M) between the new experimental subjective method (Subj.E) and the classical subjective refraction (Subj.C) was -0.034D (±0.454D). The corresponding 95% Limits of Agreement (LoA) were (-0.856D, 0.924D). In relation to precision, intra-observer mean difference for the M component was 0.034±0.195D for the Subj.C, 0.015±0.177D for the WAM and 0.072±0.197D for the Subj.E. Inter-observer variability showed worse precision values, although still clinically valid (below 0.25D) in all instruments. CONCLUSIONS The spherical equivalent obtained with the new experimental system was precise and in good agreement with the classical subjective routine. The algorithm implemented in this new system and its optical configuration has been shown to be a first valid step for spherical error correction in a semiautomated way.
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Affiliation(s)
- Jaume Pujol
- Davalor Research Center (DRC), Universitat Politècnica de Catalunya, Terrassa, Spain
| | | | - Llorenç Badiella
- Department of Applied Statistics, Universitat Autònoma de Barcelona, Spain
| | - Carles Otero
- Davalor Research Center (DRC), Universitat Politècnica de Catalunya, Terrassa, Spain.
| | - Meritxell Vilaseca
- Davalor Research Center (DRC), Universitat Politècnica de Catalunya, Terrassa, Spain
| | - Mikel Aldaba
- Davalor Research Center (DRC), Universitat Politècnica de Catalunya, Terrassa, Spain
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López-Martín O, Segura Fragoso A, Rodríguez Hernández M, Dimbwadyo Terrer I, Polonio-López B. [Effectiveness of a programme based on a virtual reality game for cognitive enhancement in schizophrenia]. Gac Sanit 2015; 30:133-6. [PMID: 26611240 DOI: 10.1016/j.gaceta.2015.10.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 10/08/2015] [Accepted: 10/13/2015] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of a programme based on a virtual reality game to improve cognitive domains in patients with schizophrenia. METHOD A randomized controlled trial was conducted in 40 patients with schizophrenia, 20 in the experimental group and 20 in the control group. The experimental group received 10 sessions with Nintendo Wii(®) for 5 weeks, 50 minutes/session, 2 days/week in addition to conventional treatment. The control group received conventional treatment only. RESULTS Statistically significant differences in the T-Score were found in 5 of the 6 cognitive domains assessed: processing speed (F=12.04, p=0.001), attention/vigilance (F=12.75, p=0.001), working memory (F=18.86, p <0.01), verbal learning (F=7.6, p=0.009), visual learning (F=3.6, p=0.064), and reasoning and problem solving (F=11.08, p=0.002). CONCLUSIONS Participation in virtual reality interventions aimed at cognitive training have great potential for significant gains in different cognitive domains assessed in patients with schizophrenia.
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Affiliation(s)
- Olga López-Martín
- Departamento de Enfermería, Fisioterapia y Terapia Ocupacional, Facultad de Terapia Ocupacional, Logopedia y Enfermería de Talavera de la Reina, Universidad de Castilla-La Mancha, Talavera de La Reina, Ciudad Real, España.
| | - Antonio Segura Fragoso
- Departamento de Enfermería, Fisioterapia y Terapia Ocupacional, Facultad de Terapia Ocupacional, Logopedia y Enfermería de Talavera de la Reina, Universidad de Castilla-La Mancha, Talavera de La Reina, Ciudad Real, España; Servicio de Investigación, Instituto de Ciencias de la Salud de Castilla-La Mancha, Talavera de la Reina, Ciudad Real, España
| | - Marta Rodríguez Hernández
- Departamento de Enfermería, Fisioterapia y Terapia Ocupacional, Facultad de Terapia Ocupacional, Logopedia y Enfermería de Talavera de la Reina, Universidad de Castilla-La Mancha, Talavera de La Reina, Ciudad Real, España
| | - Iris Dimbwadyo Terrer
- Unidad de Biomecánica y Ayudas Técnicas, Hospital Nacional de Parapléjicos, Toledo, España
| | - Begoña Polonio-López
- Departamento de Enfermería, Fisioterapia y Terapia Ocupacional, Facultad de Terapia Ocupacional, Logopedia y Enfermería de Talavera de la Reina, Universidad de Castilla-La Mancha, Talavera de La Reina, Ciudad Real, España
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Gutiérrez-Baños JL, Ballestero-Diego R, Truan-Cacho D, Aguilera-Tubet C, Villanueva-Peña A, Manuel-Palazuelos JC. Urology residents training in laparoscopic surgery. Development of a virtual reality model. Actas Urol Esp 2015; 39:564-72. [PMID: 26068072 DOI: 10.1016/j.acuro.2015.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Accepted: 04/27/2015] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The training and learning of residents in laparoscopic surgery has legal, financial and technological limitations. Simulation is an essential tool in the training of residents as a supplement to their training in laparoscopic surgery. The training should be structured in an appropriate environment, with previously established and clear objectives, taught by professionals with clinical and teaching experience in simulation. The training should be conducted with realistic models using animals and ex-vivo tissue from animals. It is essential to incorporate mechanisms to assess the objectives during the residents' training progress. OBJECTIVE We present the training model for laparoscopic surgery for urology residents at the University Hospital Valdecilla. The training is conducted at the Virtual Hospital Valdecilla, which is associated with the Center for Medical Simulation in Boston and is accredited by the American College of Surgeons. MATERIAL AND METHOD The model is designed in 3 blocks, basic for R1, intermediate for R2-3 and advanced for R4-5, with 9 training modules. The training is conducted in 4-hour sessions for 4 afternoons, for 3 weeks per year of residence. Residents therefore perform 240 hours of simulated laparoscopic training by the end of the course. For each module, we use structured objective assessments to measure each resident's training progress. RESULTS Since 2003, 9 urology residents have been trained, in addition to the 5 who are currently in training. The model has undergone changes according to the needs expressed in the student feedback. The acquisition of skills in a virtual reality model has enabled the safe transfer of those skills to actual practice. CONCLUSIONS A laparoscopic surgery training program designed in structured blocks and with progressive complexity provides appropriate training for transferring the skills acquired using this model to an actual scenario while maintaining patient safety.
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