Minimal Invasive Surgery
Murielle Brohez, MD
Digital Century
Video Games:
an Advantage for Young MIS Surgeons
Positive Effects from Previous
Studies
Early Studies evaluated psychomotor skills
Video gamers showed:
 superior eye-hand coordination
 faster reaction times
 superior spatial visualization skills
 increased capacity for visual attention
and spatial distribution
Griffith, Voloschin, Gibb, Bailey; Perceptual and Motor Skills,19832.
Yuji H; Perceptual and Motor Skills, 1996 3.
Dorval, Pepin; Perceptual and Motor
The Impact of Video Games on Training
SURGEONS in the 21st Century
Rosser Jr, MD; et al.
•
Arch Surg. 2007;142(2):181-186.
• Video games are extensively integrated into
popular culture
• Anecdotal observations of young surgeons
suggest that video game play contributes to
performance excellence in laparoscopic
surgery
• Hypothesis There is a potential link
between video game play and laparoscopic
surgical skill and suturing
• Design Cross-sectional analysis of the
performance of surgical residents and
attending physicians participating in the
Rosser Top Gun Laparoscopic Skills and
Suturing Program (Top Gun)
• Participants Thirty-three residents and
attending physicians participating in Top Gun
from May 10 to August 24, 2002.
• Main Outcome Measures The primary outcome
measures were compared between participants'
laparoscopic skills and suturing capability, video
game scores, and video game experience.
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-
Results
Video Game players 33% better (P<.005)
More than 3 h/wk >42 % better (P<.01)
Current video game players 32% fewer errors
(P=.04), performed 24% faster (P<.04), and scored
26% better overall (time and errors) (P<.005)
Conclusions
- Video game skill correlates with laparoscopic
surgical skills
- Training curricula that include video games
may help thin the technical interface between
surgeons and screen-mediated applications,
such as laparoscopic surgery
- Video games may be a practical teaching tool
to help train surgeons
Benefits of Laparoscopy
• Benefits of laparoscopy are mostly derived
postoperatively
–  pain
– attenuated stress response
– earlier return to ambulation after lap
procedures   postoperative complications
+ quicker return to full activity
Historical Background
• 1929 - Heinz Kalk, a german
gastroenterologist
• Up to 1970 – Jurgen Nord, USF
• 1987 – Phillipe Mouret, Lyons
France
Hernia
• More than 600,000
hernias are repaired
annually in the United
States
Hernia Surgery - History
Edwin Smith Papyrus
Medieval Times
Beuk repair
Techniques of Traditional Open
Repair
-Lucas-Championnière 1881
-Bassini 1889
-Lotheissen 1898
-McVay 1942
-Shouldice 1945
-Lichtenstein 1987
Laparoscopic Repair
• ? Less pain
• ? Can it be done
Anterior Abdominal Wall
Totally Extra Peritoneal
TEP anatomy
Mesh layout
Body Contour
TEP Video
TEP
•
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Indications:
Recurrent
Bilateral
Active lifestyle
• Contraindications:
- Strangulated
- Hypotensive/sepsis
TEP post-op
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SDS
Minimal narcotic intake
Return to work 3-5 days
Return to golf / running 3-5 days
Return to full activity within 10-15 days
MIS at SOMC
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Hernias
Appendectomy
Cholecysctetomy
Colectomy
Anti-reflux Surgery – Nissen Fudoplication
Diagnostic Laparoscopy
Lysis of Adhesions
Biopsies
Thank You