A New Virtual Reality Simulation Platform for Vaginal Hysterectomy

INTRODUCTION: Vaginal hysterectomy (VH) is the recommended approach for women undergoing hysterectomy for benign indications (1, 2). Despite the data supporting the advantages of VH over alternative routes, rates of VH are declining (3). With declining VH rates, both resident and fellow trainees’ exposure to and proficiency in performing VH have declined. Studies show that resident hysterectomy volumes decreased by 35.5% (4). Among first-year fellows, only 20% were able to independently perform a VH (5). To improve surgical training, many efforts have been made to develop realistic and effective hysterectomy simulators (6). Use of VR simulation models has been associated with a significant reduction in operating time and errors and has been shown to be a cost-effective training method in laparoscopic surgery (7, 8). To date, however, a VR simulation has not been evaluated for VH. OBJECTIVE: The purpose of this video submission is to introduce a new VR simulation model for VH. Our study aimed to evaluate this VR simulation platform and to present pilot data on the validity and reliability of the platform as a training tool for VH. METHODS: This was a cross-sectional observational pilot study that recruited a minimum of 20 participants, including 10 OB/GYN trainees and 10 attending faculty who routinely perform VH. Each participant completed a demographics questionnaire, watched a brief instructional video outlining procedural steps, completed a VR tutorial, and finally performed a VH using the VR platform. The primary outcomes included the face and content validity of the VR platform as measured by participant Likert ratings of the model as a training and assessment tool and ratings of the model’s performance for each essential procedural step. Likert ratings are reported as the frequency and percentage of responses received for each assessment question. RESULTS: The VR VH simulation was reported as “effective” in terms of its use as a simulation tool for VH training by 61.5% of participants. 46.2% of participants felt that the model was “somewhat effective” for simulating the steps of a VH much like a live patient, and 38.5% of participants felt that the simulation was “highly effective” for terms of impact on patient safety. When asked about the VR model’s ability to simulate specific steps of a VH, most participants rated the model as either “somewhat effective” or “effective.” CONCLUSIONS: Preliminary findings suggest that this VR model demonstrates acceptable face and content validity for VH training. These results support its potential role as a supplemental tool to improve surgical education and patient safety.