Mp68-18 end to end assessment of suturing expertise (ease) in virtual reality surgical simulation with associated clinical outcomes

You have accessJournal of UrologyCME1 Apr 2023MP68-18 END TO END ASSESSMENT OF SUTURING EXPERTISE (EASE) IN VIRTUAL REALITY SURGICAL SIMULATION WITH ASSOCIATED CLINICAL OUTCOMES Timothy N. Chu, Runzhuo Ma, Alvin Hui, Oscar Gomez, Cherine H. Yang, Istabraq S. Dalieh, Elyssa Y. Wong, Ahmed Ghazi, John W. Davis, Brian J. Miles, Clayton Lau, and Andrew J. Hung Timothy N. ChuTimothy N. Chu More articles by this author , Runzhuo MaRunzhuo Ma More articles by this author , Alvin HuiAlvin Hui More articles by this author , Oscar GomezOscar Gomez More articles by this author , Cherine H. YangCherine H. Yang More articles by this author , Istabraq S. DaliehIstabraq S. Dalieh More articles by this author , Elyssa Y. WongElyssa Y. Wong More articles by this author , Ahmed GhaziAhmed Ghazi More articles by this author , John W. DavisJohn W. Davis More articles by this author , Brian J. MilesBrian J. Miles More articles by this author , Clayton LauClayton Lau More articles by this author , and Andrew J. HungAndrew J. Hung More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003331.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Virtual reality (VR) provides a standardized setting for surgical skill assessment but currently lacks high-level multi-institutional evidence to validate the predictive value of VR. We have previously developed a granular suturing assessment tool (EASE), which can accurately distinguish surgeon experience in live surgery. This present study aims to further validate EASE in a VR environment and evaluate the utility of VR as a tool to predict clinical outcomes. METHODS: 21 surgeons in this prospective five-center study completed VR simulation suturing exercises on the Surgical Science™ Flex VR simulator (Fig 1A). 5 independent and blinded graders received standardized training and provided technical skill assessment for VR using EASE. EASE was adapted to be relevant for a simulated environment (EASE-VR). Inter-rater reliability was measured using prevalence-adjusted bias-adjusted kappa (PABAK) with agreement >0.6 in all graded subskills. Expert (>100 robotic cases) and trainee (<100 cases) scores were compared using generalized estimating equation. Correlations for expert surgeon EASE-VR scores and post-surgical clinical outcomes were calculated using Cox regression while controlling for patient factors (age, BMI, preoperative PSA, biopsy Gleason Score, pathological tumor stage). RESULTS: 7 trainees (median caseload 60, range 0-80) and 14 expert surgeons (1500, range 275-3000) participated in this study. In VR, experts had significantly better Needle Handling (hold anglep=0.048) and Needle Driving (wrist rotation p=0.014) scores compared to trainees. There were no statistically significant differences in all other domains (p>0.05). For expert surgeons, Needle Driving (wrist rotation) was not significantly associated with urinary continence recovery. Expert Needle Handling (hold angle) scores were found to have a significant positive association with urinary continence recovery (Hazard Ratio 2.11, 95% Confidence Interval 1.44-3.09, p<0.001) (Fig 1B). CONCLUSIONS: EASE-VR can distinguish surgical experience in VR simulation exercises. Our results suggest that expert surgeon EASE-VR scores have positive association with post-surgical clinical outcomes. Source of Funding: Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Number R01CA251579. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e960 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Timothy N. Chu More articles by this author Runzhuo Ma More articles by this author Alvin Hui More articles by this author Oscar Gomez More articles by this author Cherine H. Yang More articles by this author Istabraq S. Dalieh More articles by this author Elyssa Y. Wong More articles by this author Ahmed Ghazi More articles by this author John W. Davis More articles by this author Brian J. Miles More articles by this author Clayton Lau More articles by this author Andrew J. Hung More articles by this author Expand All Advertisement PDF downloadLoading ...