Aktueller Stand virtueller Simulatoren für die chirurgische Ausbildung in Orthopädie und Unfallchirurgie

Practical surgical training in orthopedics and trauma surgery is becoming more and more difficult due to increasing economic pressure. In addition, more and more interventions are carried out on an outpatient basis. This particularly applies to arthroscopy, which also places high demands on the skills of the surgeon. Therefore, numerous virtual arthroscopy simulators have been developed over the past 20 years. These are virtual desktop systems that are coupled with a joint simulator, which allow tactile feedback. In this way basic arthroscopic skills (e.g. triangulation) or arthroscopic operations (e.g. partial meniscectomy) can be trained. The systems enable success control by recording various parameters (surgical time, camera and instrument path length, cartilage contact). Specific simulators already exist for all major joints. Scientific data are now available on face validity, content validity, construct validity and transfer validity of these systems. The skills learned can therefore be transferred to success in the operating room. The cost efficiency of these systems has so far not been resolved. Immersive virtual reality (VR) systems using 3D goggles and tactile hand sensors must be distinguished from desktop joint model systems. The participants usually join the application as an avatar. Immersive systems are therefore particularly suitable for simulating open surgical procedures (e.g. hip arthroplasty). Initial studies have also shown evidence for the use of immersive virtual reality for content, construct and transfer validity when training various open operations. Further developments are to be expected here in the future.