Does Virtual ‘Warm-up’ Improve Surgical Performance?

Researchers at University of Washington Medicine will lead a three-year multicenter study to see whether the practice leads to faster, more effective work — and fewer errors.


Below is an excerpt from the UW Health Sciences News Beat written by Michael McCarthy:

credit: Clare McLean

Dr. Thomas Lendvay demonstrates the virtual reality program surgeons will use to ‘warm up’ before operating.  photo credit: Clare McLean

The study will enroll surgeons operating with robotic surgery systems, through which surgeons manipulate surgical instruments remotely with computer assistance. This assistance gives the surgeon exquisite control over their instruments and allows them to perform complex procedures through dime-sized incisions.

In the study, the surgeons will be randomly assigned to perform operations with and without warm-up. The warm-up will consist of performing a set of tasks in a virtual reality program that will mimic tasks commonly performed during surgery. The surgeons’ performance during the first 15 minutes of each operation with or without a warm-up will then be compared.

The study, which is being funded by a $1.35 million grant from the U.S. Department of Defense, will be led by Thomas Lendvay, a UW associate professor of urology and a pediatric urologist at Seattle Children’s Hospital, and Timothy Brand, urologic surgeon at Madigan Army Medical Center in Tacoma.

“In athletics, music and other activities in which you are required to perform both complex physical and mental tasks at the same time, performers typically warm-up beforehand. This has been shown to improve performance,” said Lendvay. “We want to see whether a short, standardized, pre-operative warm-up can improve the performance of surgeons as well.”

In a previous study, Lendvay and Brand looked at how a short warm-up in a separate virtual reality computer program affected a surgeon’s ability to perform a variety of tasks with the robotic surgery system, such as suturing and placing small rings on pegs mounted on slowly gyrating pegboards. The researchers found that after the virtual reality warm-up the surgeons were faster, worked more economically and, importantly, made fewer errors while suturing.

Thomas Lendvay looks on as Justin Ahn, a resident at UW Medical Center, practices suturing in the virtual reality program.

“The warm-ups appear to help the surgeon to reach a mental state where actions like suturing don’t require a lot of attention,” Lendvay said. “This means they can spend less time thinking about suturing and more on the decisions they have to make as the operation proceeds.”

If the study finds that the warm-up significantly improves the surgeon’s performance, Lendvay envisions that warm-up could become part of routine pre-operative preparations.

“We are hoping to design a short, standardized warm-up protocol that will improve performance for a wide variety of procedures,” he said.

The study will be conducted in collaboration with a University of Washington team led by Blake Hannaford, professor of electrical engineering and director of the Biorobotics Laboratory, and another UW Medicine urologist, Mathew Sorenson at VA Puget Sound Health Care System, as well as the University of Minnesota, Florida Hospital System’s Nicholson Center and Madigan Army Medical Center.

Click here to learn more about using the dV-Trainer for surgical warm-up or visit MShare, Mimic’s online curriculum sharing portal, to download a Surgical Warm-up curricula for your dV-Trainer.

For more information on robotic surgery simulation training click here to contact a Mimic Representative.