Murielle Brohez, MD

Minimal Invasive Surgery

Digital CenturyDigital Century

Video Games:Video Games:an Advantage for Young MIS Surgeonsan Advantage for Young MIS Surgeons

Positive Effects from Previous Positive Effects from Previous StudiesStudies

Early Studies evaluated psychomotor skills Video gamers showed:

superior eye-hand coordinationfaster reaction timessuperior spatial visualization skillsincreased 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 The Impact of Video Games on Training SURGEONS in the 21st CenturySURGEONS in the 21st Century

Rosser Jr, MD; et al.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.

• 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)

ConclusionsConclusions

- 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 LaparoscopyBenefits 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 BackgroundHistorical Background

• 1929 - Heinz Kalk, a german gastroenterologist

• Up to 1970 – Jurgen Nord, USF

• 1987 – Phillipe Mouret, Lyons France

HerniaHernia

• More than 600,000 hernias are repaired annually in the United States

Hernia Surgery - HistoryHernia Surgery - History

Edwin Smith Papyrus

Medieval TimesMedieval Times

Beuk repairBeuk repair

Techniques of Traditional Open Techniques of Traditional Open RepairRepair

-Lucas-Championnière 1881

-Bassini 1889

-Lotheissen 1898

-McVay 1942

-Shouldice 1945

-Lichtenstein 1987

Laparoscopic RepairLaparoscopic Repair

• ? Less pain

• ? Can it be done

Anterior Abdominal WallAnterior Abdominal Wall

Totally Extra PeritonealTotally Extra Peritoneal

TEP anatomyTEP anatomy

Mesh layoutMesh layout

Body ContourBody Contour

TEP VideoTEP Video

TEPTEP

• Indications:- Recurrent- Bilateral- Active lifestyle

• Contraindications:- Strangulated- Hypotensive/sepsis

TEP post-opTEP post-op

• 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 SOMCMIS at SOMC

• Hernias• Appendectomy• Cholecysctetomy• Colectomy• Anti-reflux Surgery – Nissen Fudoplication• Diagnostic Laparoscopy• Lysis of Adhesions• Biopsies

Thank YouThank You