VIRTUAL-REALITY IN SURGICAL EDUCATION

Virtual reality (VR) is an emerging-technology that can teach surgeons new procedures and can determine their level of competence before the y operate on patients. Also VR allows the trainee to return to the sam e procedure or task several times later as a refresher course. Laparos copic surgery is a new operative technique which requires the surgeon to observe the operation on a video-monitor and requires the acquisiti on of new skills. VR simulation could duplicate the operative field an d thereby enhance training and reduce the need for expensive animal tr aining models. Our preliminary experience has shown that we have the t echnology to model tissues and laparoscopic instruments and to develop in real time a VR learning environment for surgeons. Another basic ne ed is to measure competence. Surgical training is an apprenticeship re quiring close supervision and 5-7 years of training. Technical compete nce is judged by the mentor and has always been subjective. If VR surg ical simulators are to play an important role in the future, quantitat ive measurement of competence would have to be a part of the system. B ecause surgical competence is ''vague'' and is characterized by such t erms as ''too long, too short'' or ''too close, too far,'' it is possi ble that the principles of fuzzy logic could be used to measure compet ence in a VR surgical simulator. Because a surgical procedure consists of a series of tasks and each task is a series of steps, we will plan to create two important tasks in a VR simulator and validate their, u se. These tasks consist of laparoscopic knot tying and laparoscopic su turing. Our hypothesis is that VR in combination with fuzzy logic can educate surgeons and determine when they are competent to perform thes e procedures on patients.