Surgical Simulator, the LaparoscopyVR™: OB/GYN Module

Laparoscopy OB/GYN Simulation

The goals for the LapVR™ Surgical Simulator's OB/GYN module are to develop technical and cognitive skills and dexterity for three major laparoscopic OB/GYN surgical procedures.

Surgical simulation training using the OB/GYN module provides practice in ectopic pregnancy surgical intervention, tubal occlusion and salpingo-oophorectomy.

Since 1970, the frequency of ectopic pregnancy has increased six-fold, now occurring in 2% of all pregnancies.(1) Ectopic pregnancy is the leading cause of maternal mortality in the first trimester and accounts for up 15% of all maternal deaths.(2)

"Ectopic pregnancy is a medical emergency with 70,000 cases occurring annually and approximately 40 to 50 American women dying from it yearly. Because of the emergent nature of this condition, there is a need for a high fidelity simulator to provide training in laparoscopic treatment of ectopic pregnancy. The OB/GYN module provides valuable training in both procedures, salpingostomy (to preserve the tube to maintain fertility if possible) and salpingectomy (tube removal)", said Dr Stepp, assistant professor, Case Western University at Metro Health Medical Center. "Simulation training for OB/GYN laparoscopic procedures is an excellent and necessary adjunct to the training of future OB/GYN surgeons."

Tubal occlusion is the second preferred method of birth control, next to oral contraceptives. The LapVR OB/GYN module allows the user to practice with cutting, clipping, and electrosurgery and with various patient cases.

Salpingo-oophorectomy, the removal of the fallopian tubes and ovaries, is performed to treat ovarian or other gynecological cancers or infections caused by pelvic inflammatory disease.

For each of the LapVR surigcal simulator's OB/GYN procedures, various cases, with a multitude of parameters, are available for user customization. As an example, the degree of fragility of the blood vessels that will lead to easier and quicker bleeding during surgery is an adjustable parameter.

Virtual Laparoscopy OB/GYN Training Objectives

The OB/GYN surgical simulation module builds laparoscopic skills, helping the user:

• Practice common OB/GYN surgical procedures
• Perform conservative and emergent procedures for tubal pregnancy
• Learn to choose the surgical method most appropriate for the patient
• Practice various methods of surgical intervention, clipping, cutting, electrosurgery, and retrieval
• Improve technical and cognitive abilities required for laparoscopic OB/GYN surgical procedures
• Review an end-of-practice assessment, identifying areas of strength and those needing improvement
• Obtain confidence in performing laparoscopic OB/GYN surgical procedures before introduction to real patient scenarios
• Learn to choose the correct and most efficient approaches to handling anatomical deviations

(1) Sepilian, Vicken P. 2007. Ectopic Pregnancy. Emedicine. http://www.emedicine.com/med/topic3212.htm (accessed August 23, 2007).

(2) Tenore, Josie L. 2000. Ectopic Pregnancy. American Family Physician. http://www.aafp.org/afp/20000215/1080.html (accessed August 23, 2007).