Page 3 - World Journal of Laparoscopic Surgery

ORIGINAL RESEARCH
Efficacy of Serious Game Training in Comparison with

the Traditional Training in Learning the Laparoscopic

Cholecystectomy Skills: An Interventional Analytic Study

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Zohrehsadat Mirmoghtadaie , Mansour Bhahrdoust , Adnan Tizmaghz , Ghazaal Shabestanipour 4
AbstrAct
Background: Performing a laparoscopic cholecystectomy (LC) surgery requires a high level of experience, and complementary training methods
are demanded. In this study, we evaluated the efficacy of serious game LC training compared to the traditional LC training in laparoscopic
cholecystectomy skills of junior residents.
Materials and methods: Forty-four junior residents with no history of LC performance were assigned to either the serious game training group
(case group, n = 22) or the traditional (Zollinger’s Atlas of Surgical Operations) training group (control group, n = 22). Participants were allowed
to perform the operation only when they achieved a score of more than 80% in the theory checklist.
Results: The mean LC skills score based on the pre-surgery theory checklist was 84.5 ± 11.1% in the case group and 68.2 ± 17.6% in the control
group (p = 0.021). The total number of attempts needed to reach an 80% score in the theory checklist was 2.97 ± 1.40 in the case and 4.17 ± 2.03
in the control group (p = 0.001). The mean operation time and the number of attempts needed to complete the operation without complications
were significantly lower in the case group (p = 0.028 and p = 0.041, respectively). The final skills score was 90.8 ± 9.2% in the case group and
80.1 ± 14.2% in the control group (p = 0.012).
Conclusion: Serious game training was more effective than traditional training in all aspects of LC performance. Therefore, broader usage of
the serious game for LC training is recommended.
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Keywords: Laparoscopic cholecystectomy, Serious game, Touch Surgery .
World Journal of Laparoscopic Surgery (2022): 10.5005/jp-journals-10033-1523

IntroductIon
1 Department of e-Learning, Virtual School of Medical Education and
Traditionally, surgical learning and teaching are largely based on Management, Shahid Beheshti University of Medical Sciences, Tehran,
the use of animals and cadavers. The advent of minimal invasive Iran
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surgeries (MIS) has led to decreased surgical morbidity. Meanwhile, 2 Department of Epidemiology, School of Public Health, Shahid
MIS techniques are associated with an increased demand for Beheshti University of Medical Sciences, Tehran, Iran
education and training because of a very small workspace and 3 Department of General Surgery, Iran University of Medical Sciences,
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lack of a direct view of the organs under operation. Therefore, Tehran, Iran
the development of new learning and teaching approaches are 4 Iran University of Medical Sciences, Tehran, Iran
of considerable value to improve surgical skills such as eye-hand
coordination in the context of MIS procedures. 1 Corresponding Author: Adnan Tizmaghz, Department of General
Laparoscopic cholecystectomy is a widely used MIS technique Surgery, Iran University of Medical Sciences, Tehran, Iran, Phone: +98
2164352215, email: adnan_ti@yahoo.com
that is associated with significant improvement in patient outcomes
and considerable reduction in the healthcare burden for patients How to cite this article: Mirmoghtadaie Z, Bhahrdoust M, Tizmaghz A,
et al. Efficacy of Serious Game Training in Comparison with the
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with biliary tract disease. Despite these advantages, similar to Traditional Training in Learning the Laparoscopic Cholecystectomy
the other MIS techniques, LC requires a high level of experience Skills: An Interventional Analytic Study. World J Lap Surg 2022;15(2):
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to result in satisfactory outcomes. Therefore, extra education of 99–102.
surgeons through an attractive alternative way of learning is of Source of support: Nil
critical importance. Conflict of interest: None
Currently, training using computer simulation, also known as
virtual reality (VR) training, is widely used for laparoscopic training
and has proved to be an effective tool for improving laparoscopic the trainees, thereby offering a challenging yet motivational
skills, particularly for those surgical residents who underutilize opportunity to learn due skills. 5
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traditional simulation training. Serious games are referred to the Touch Surgery™ is considered as a serious gaming mobile
games with the primary purpose of teaching and learning instead application designed for surgical training, and its validity for cognitive
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of entertainment. These innovative VR training applications contain training and assessment of key LC steps has been demonstrated.
a high simulation potential for skills that are required for specific In this study, we evaluate how it affects the clinical skills of surgical
surgeries. The complex interactive context of serious games engages assistants when compared with the traditional training modality.

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