Minimally Invasive Surgery: VR Simulators for Training

Interview with Marc Pflüger, Marketing Manager Simulation, KARL STORZ GmbH & Co. KG


More and more surgical interventions are minimally invasive. For these surgeries to be successful, medical training and continuing education of surgeons are essential. Virtual reality simulators are one way to train minimally invasive procedures. This was the topic of Marc Pflüger's lecture at DiMiMed 2016.

Image: Marc Pflüger ; Copyright: beta-Web/Wart

The topic of Marc Pflüger's speech was "VR Simulators: Virtual Reality Training to get prepared for real life"; © beta-Web/Wart

How can we imagine virtual reality training?

Marc Pflüger: Minimally invasive surgery (MIS) places special demands on the medical training and continuing education of surgeons. Virtual reality training simulators used in the surgical field give physicians the chance to learn the technical aspects of MIS in a controlled environment under standardized conditions. Training simulators can help to improve the proper handling of instruments as well as their navigation in a three-dimensional setting with the help of a two-dimensional monitor. They can also efficiently teach specific steps of surgery. In addition, surgical trainees can practice and train on these computer-based simulation systems as often as they like or need.

Your lecture topic is "VR Simulators: Virtual Reality Training to get prepared for real life". What do you actually mean by "real life"?

Pflüger: By "real life" I mean everyday surgical practice. Even though the VR simulators allow you to train in a risk-free environment, thanks to the high degree of realism in the graphics, the original equipment that's being used and the realistic patient cases with their occurring complications, trainees virtually feel like they are in a "real life" setting and not just in a training situation. KARL STORZ VR simulators can be used for applications in gynecology, urology and arthroscopic surgery for example.

What are the benefits of VR simulators as training devices compared to other methods?

Pflüger: VR simulators are always available training solutions in a completely risk-free environment that provide a high degree of realism thanks to their actual original equipment and the realistic patient cases.

Another benefit is the so-called "digital mentor". It enables independent yet still guided training with the VR simulator. That is to say, the supervision by experienced physicians needed with other methods, can – at least in part- be eliminated. What's more, there are reproducible and comparable tasks, including management of complications. They are assessed with the help of a feedback report to individually measure performance parameters. In addition, all exercises are recorded so that they can be later accessed at any time and analyzed together with the tutor.

Another aspect is that neither medical consumables nor reprocessing for surgical instruments are required when you train at VR simulators. Lastly, VR simulators allow surgeons to train procedures for which there are otherwise no or only insufficient training methods available. One example of this is the option to train "Photodynamic Diagnostics" (PDD) with the KARL STORZ UroTrainer.

What are the limitations of training with virtual reality simulators?

Pflüger: The fact that at least for now, not all surgical procedures are or can be simulated yet is one restriction of training with VR simulators. Some surgical procedures such as basic techniques like laparoscopic suturing and knot tying can be trained far more efficiently with simple laparoscopic trainer boxes. Even though they are technically feasible, VR simulation is not the best training method for these types of training tasks.

Having said that, there are definitely surgical procedures that cannot be imitated with today's available VR simulators due to their complexity and since the programming effort is either too high or the computer processing power is too low.

It has to be pointed out that generally, training with VR simulators is not intended to replace any existing training methods but aims to complement or improve them.

Do you think virtual reality training will be used more and more in the future? Perhaps also in light of the fact that graphics become increasingly realistic?

Pflüger: Yes. Technological progress, the increasing mandatory acceptance of VR simulators in medical education curriculums, as well as the corresponding cost benefits, will definitely increase the application of VR simulation in surgical training and continuing education.

The interview was conducted by Olga Wart.