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["I will do laparoscopy somewhere else" : Total, highly immersive virtual reality without side effects?]

BACKGROUND: For virtual reality laparosopic simulation we developed a new, highly immersive simulation mode. The goal of the current pilot study was to investigate if kinetosis or other negative vegetative side effects can be caused by a total virtual training set-up (TVRL).

METHODS: In this study 20 participants with varying degrees of expertise in laparoscopy performed 3 tasks (i.e. ring exchange, fine dissection and cholecystectomy) in regular (VRL) and immersive mode (TVRL) with a head-mounted display (HMD) on a laparoscopic simulator. Aside from performance scores, the heart rate was recorded and the occurrence of vertigo was investigated.

RESULTS: Surgical performance was independent of the VR mode (VRL or TVRL). Participants' heart rate was higher in TVRL without reaching statistical significance. Kinetosis occurred in two participants (10%) with a history of motion sickness.

CONCLUSION: Laparoscopic training can take place in a total virtual environment with limited nagative vegetative side effects. Special attention should be paid to participants with a history of motion sickness. The development of TVRL enables new perspectives for surgical training.

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