Surgical Simulation: A Urological Perspective

Wignall, Geoffrey R.; Denstedt, John D.; Preminger, Glenn M.; Cadeddu, Jeffrey A.; Pearle, Margaret S.; Sweet, Robert M.; McDougall, Elspeth M.

doi:10.1016/j.juro.2008.01.014

« Previous Next »The Journal of Urology
Volume 179, Issue 5 , Pages 1690-1699, May 2008

Surgical Simulation: A Urological Perspective

Geoffrey R. Wignall
- Division of Urology, University of Western Ontario, London, Ontario, Canada
John D. Denstedt
- Division of Urology, University of Western Ontario, London, Ontario, Canada
- Correspondence: Division of Urology, University of Western Ontario, 268 Grosvenor St., London, Ontario, Canada N6A 4V2 (telephone: 519-646-6036; FAX: 519-646-6037).
- Financial interest and/or other relationship with Boston Scientific, Cook Urological and Olympus.
Glenn M. Preminger
- Division of Urology, Duke University Medical Center, Durham, North Carolina
- Financial interest and/or other relationship with Mission Pharmacal and Boston Scientific.
Jeffrey A. Cadeddu
- Department of Urology, University of Texas, Southwestern Medical Center at Dallas, Dallas, Texas
Margaret S. Pearle
- Department of Urology, University of Texas, Southwestern Medical Center at Dallas, Dallas, Texas
- Financial interest and/or other relationship with Cook Urological, Boston Scientific and Percutaneous Systems.
Robert M. Sweet
- Department of Urologic Surgery, University of Minnesota, Minneapolis, Minnesota
- Financial interest and/or other relationship with Medical Education Technologies, Inc. and Red Llama Technologies Inc.
Elspeth M. McDougall
- Department of Urology, University of California, Irvine, Irvine, California
- Financial interest and/or other relationship with Astellas, Karl Storz, Intuitive Surgical, Simbionix, Ethicon Endo-Surgical, EndoCare and METI, Inc.

Received 6 July 2007 published online 17 March 2008.

Purpose

Surgical education is changing rapidly as several factors including budget constraints and medicolegal concerns limit opportunities for urological trainees. New methods of skills training such as low fidelity bench trainers and virtual reality simulators offer new avenues for surgical education. In addition, surgical simulation has the potential to allow practicing surgeons to develop new skills and maintain those they already possess. We provide a review of the background, current status and future directions of surgical simulators as they pertain to urology.

Materials and Methods

We performed a literature review and an overview of surgical simulation in urology.

Results

Surgical simulators are in various stages of development and validation. Several simulators have undergone extensive validation studies and are in use in surgical curricula. While virtual reality simulators offer the potential to more closely mimic reality and present entire operations, low fidelity simulators remain useful in skills training, particularly for novices and junior trainees. Surgical simulation remains in its infancy. However, the potential to shorten learning curves for difficult techniques and practice surgery without risk to patients continues to drive the development of increasingly more advanced and realistic models.

Conclusions

Surgical simulation is an exciting area of surgical education. The future is bright as advancements in computing and graphical capabilities offer new innovations in simulator technology. Simulators must continue to undergo rigorous validation studies to ensure that time spent by trainees on bench trainers and virtual reality simulators will translate into improved surgical skills in the operating room.

Key Words: computer simulation, education, surgery, endoscopy, laparoscopy

Abbreviations and Acronyms: AUA, American Urological Association, MISTELS, McGill Inanimate System for Training and Evaluation of Laparoscopic Skills, TURP, transurethral prostate resection, VR, virtual reality