Impact of mixed reality application on the learning curve of laparoscopic nephrectomy
Abstract
Aim - to evaluate the effectiveness and safety of mixed reality (MR) in
surgeon's learning curve for laparoscopic nephrectomy (LNE).
Material and methods. There were 40 prospectively recruited patients that
have undergone LNE; in 20 patients, the results of contrast-enhanced multislice
computed tomography of the urinary system (MSCT US) were converted to MR
models. The MR platform allowed surgeons to rotate and disassemble the
anatomy of the kidneys during the preoperative phase, as well as directly
during the surgery; patients could also see their anatomical structures
while having the surgical procedure explained step-by-step. The Likert
scale questionnaire allowed to assesse the understanding and usefulness of
the MR model in anatomical kidney surgery. The surgeons involved in the study
also commented on whether MR affected their learning curve. Surgical
outcomes for the MR patient cohort were compared with a prospectively matched
cohort of LNE patients without MR.
Results. The mean operative time in the MR group was
significantly lower than in the non-MR group (78.5 versus 95.6 min; p<0.05). The differences in the
indices of intraoperative blood loss were 58 versus 150 ml (p=0.081). Postoperative complications 5
versus 15% (p=0.09) for the
MR group and the non-MR group, respectively. There was no significant
difference in the length of hospital stay between the 2 groups (72±4
versus 48±5 hours, p=0.01). The
novice surgeon reached a plateau after 20 surgical procedures.
Conclusion. The preoperative review of MR models changed the
on-line approach, shortened surgery time, and improved LNE results. The
implementation of mixed reality technology in the course of teaching the
technique of laparoscopic nephrectomy demonstrated positive results in terms of
the speed of reaching the plateau of surgical procedures without any
complications. The process of preparing and using a volumetric model of an
organ in the course of LNE training did not cause difficulties for
specialists, and lead to an acceleration of operation in the technique
training without loss of quality.
Keywords:laparoscopic nephrectomy, learning curve, mixed reality, HLOIA©, kidney tumour
Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Gabdullin A.F., Pogosyan R.R., Dzhalilov I.B.,
Gadzhiev N.K., Semeniakin I.V. Impact of mixed reality application on the
learning curve of laparoscopic nephrectomy. Clinical and Experimental Surgery.
Petrovsky Journal. 2021; 9 (4): 124-30. DOI: https://doi.org/10.33029/2308-1198-2021-9-4-124-130 (in Russian)
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