Modern surgery has largely shifted from direct hands-on maneuvers to indirect "minimal access" procedures, usually involving internal cameras which monitor the actions of instruments that the surgeon cannot see directly. The internal view is typically observed via video monitors in the operating room, resulting in a "hand-eye disconnect" which can initially be quite disconcerting.

While experienced surgeons sometimes have difficulty adapting to this new surgical paradigm, it is often suggested that the incoming generation of medical residents may be better prepared to learn modern endoscopic surgery because of their experience with video games. As part of a long-term program looking at the utility of simulation for surgery training, the Surgical Simulation Working Group (an interdisciplinary team led by Dr. Mika Sinanan, Director of the UW's Center for Videoendoscopic Surgery and a HIT Lab associate) recently completed a study of the relationship between video game performance and laparascopic surgery skill.

Since laparoscopic surgery requires the coordination of two hands holding instruments that are seen from the perspective of an internal endoscope camera, for the video game test we chose a two-handed 3D version of the popular Tetris game. For each of the 40 surgery residents tested we measured performance on the video game in a 15-minute period and the efficiency with which they performed a simulated gall bladder removal (laparoscopic cholecystectomy), using a physical simulator from SimuLabs, Inc., in a full operating room setup. Each resident was "attended" by an experienced surgeon, as they would be during an actual procedure.

Surgical experience was the strongest predictor of performance on the simulated surgery, as we would expect. But, for first-year surgery residents (the largest group tested) we also found a positive correlation with video game score. While this result does not tell us much about causal relationships, it does suggest that the two tasks require similar skills. The Working Group is currently planning follow-up studies to further explore this interesting finding.

Currently, the group is focusing on:

  • defining the benefits of simulation to training in skills and procedures
  • documenting clinical benefit from simulation
  • documenting increased efficiency from simulation training
  • developing a virtual port-site plannin simulation model with the HITL
  • validating measures of expert clinical performance through index simulation tests
  • investigation the potential for credentialing by measurement of performance in objective skills tests
  • interfacing with the "intelligent" haptic grasper being developed in the Biorobotics lab