SRS365 - Three-dimensional microsurgical skill acquisition: a randomised controlled study comparing laboratory microscope training, video gaming, and virtual reality

Abstract Introduction/Background Mastering microsurgical motor skills presents considerable challenges. Approaches to microsurgical skills acquisition have evolved with technological advancements. Research indicates conventional training using 2D microscopes in the laboratory setting significantly improves novices’ microsurgical abilities. It remains unclear whether these skills are transferable to the 3D microscope or if gaming dexterity could play a more crucial role in skill acquisition. We present a randomised control trial comparing three interventions: conventional laboratory microscope training (LM), high-fidelity video gaming (Sony PlayStation4 console; VG) and high-fidelity virtual reality gaming (Sony PlayStation VR console; VR), against a control group. Methods 40 medical students with no prior experience were block randomised to four groups of 10: control (no intervention), LM, VG, and VR. Participants performed chicken femoral artery anastomosis using the Aesculap Aeos® 3D microscope system before and after their assigned intervention. Performance evaluation included a modified structured assessment of microsurgery skills (mSAMS) score, total anastomosis time and suture efficiency, assessed by two independent, blinded evaluators. Results Pre-intervention assessments showed no significant difference between groups. Post-intervention, the LM group demonstrated statistically significant improvements in mSAMS scores (8.80 to 16.55) and suture efficiency (0.067 to 0.139 sutures/min) compared to baseline performance. Conversely, the VG, VR and control groups showed no statistically significant changes. Conclusions During early stages of microsurgical training, intensive laboratory-based training significantly improves a novice’s anastomotic performance on a 2D microscope. Importantly, these skills appear transferable to 3D anastomosis. Contrastingly, focused gaming interventions had no significant effect, with results comparable to non-intervention group.