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The Impact of Video Game Experience on Surgical Performance: A Systematic Review.

OBJECTIVE: To assess whether video gaming experience is associated with improved surgical performance in the surgeon population across laparoscopic, robotic, and other surgical modalities, and evaluate its implications on surgical training and education. METHODS: A structured literature search was conducted across five databases on 29th November 2024 in adherence to PRISMA guidelines. Comparative studies evaluating surgical performance outcome data between surgeons with differing video game experience were eligible for inclusion. Outcomes evaluated were time to complete task, error rate, accuracy, economy of motion, and overall score. Included studies were assessed for risk of bias using ROBINS-I and RoB 2. RESULTS: 15 studies involving 641 participants were included, comprising one randomized controlled trial and 14 nonrandomized studies. All nonrandomized studies were judged to be at moderate or serious risk of bias, and the single randomized controlled trial was judged to be at serious risk of bias. Differences in study design and outcome measures meant that quantitative synthesis could not be performed. Across laparoscopic studies, video gaming experience was associated with improved overall score and time to task completion predominantly in the period prior to structured training interventions, with accuracy findings consistently favoring gamers in the two studies reporting this outcome. Error rate and economy of motion findings were inconsistent or predominantly nonsignificant. No meaningful association was identified across nonlaparoscopic modalities. CONCLUSIONS: Video gaming may be associated with improved surgical performance in surgeons, though this appears restricted to laparoscopic tasks and the pretraining intervention period. As a low-cost and accessible activity, video gaming may represent a practical informal adjunct to formal surgical training to help ease the transition into structured technical training. Surgical program directors need not alter existing selection criteria or training modules based on the available literature.

Video Games

Dexterity testing and residents' surgical performance.

1. With some exceptions, those who choose ophthalmology as a career may approximate the general population in innate manual dexterity. 2. Many factors other than manual dexterity influence the development of surgical skills by residents. 3. If dexterity testing is to be used, the addition or inclusion of tests for spatial aptitudes may be more helpful than simple dexterity tests alone. The predictive value of such tests for surgical performance would need vertification. 4. The development of a special test directly related to handling surgical instruments, to cutting, and to sewing (the criteria) may be more practical than the ones used in this study.

Aptitude Tests

[New classification of practical surgical performance].

The commission was founded in April 1990 by the Professional Association of German Surgeons to devise a new evaluation of surgical practice, especially operative procedures. The catalogue uses time as its first approach, but also gives other qualities for surgical work. The given time values for some standard operations are backed up by statistical calculation of well-documented times in three different surgical units.

Cost-Benefit Analysis

Surgical procedures performed after refractive surgery.

BACKGROUND: Refractive surgical procedures have been performed for over one decade. The complications that cause visual disability are abnormalities in wound healing, residual ametropia, and/or severe irregular astigmatism. Many of these complications can be manifested clinically in terms of visually disabling problems (loss of best-corrected vision, glare, monocular diplopia, etc). Some of these complications require additional standard ophthalmic or refractive surgical procedures to restore vision. However, since these secondary procedures have been performed in only a few cases, we known little about their outcome. METHODS: We report the histopathologic analysis of 132 cases that have undergone a secondary surgical procedure following a primary keratorefractive procedure. We attempt to correlate the problems encountered with such secondary intervention with histopathologic information obtained from specimens that have been submitted to our pathology laboratory and that had undergone secondary surgical procedures. RESULTS: Many specimens displayed abnormalities in wound healing associated with visual difficulties such as loss of best corrected acuity, glare, and under- and overcorrection. A short time from the initial procedure to the time of secondary intervention was common. CONCLUSIONS: The combination of a secondary surgical or keratorefractive procedure can produce unpredictable refractive results. Judicious application of a refractive procedure and an appropriate time period before a second procedure is performed may reduce unexpected refractive complications.

Adult

Mechanical performance of surgical sutures.

A comprehensive analysis of the mechanical performance of sutures has been made to provide information concerning the reliability and security of knotted sutures. The tests utilized in this analysis were designed to be easily reproduced by other investigators. The construction of the knot and the knot performance analysis were undertaken utilizing an Instron Tensile Tester. The mechanical reliability of each knotted suture was determined by measuring the number of throws to reach knot break, the expected slippage of the knot when it reaches knot break, and the maximal holding force at knot break. On the basis of these measurements, recommendations are made for the use of a suture at operation.

Biomechanical Phenomena

[Assessing performance in surgical research and teaching].

The clinical registration of performance mainly serves to ascertain the staff plan. The measure of teaching and research is not quality but quantity in hours. For teaching, the time of lectures is taken with an added factor of 1.5 for lectures and 0.5 for practical training for preparation. For research it is customary to take an index of 10% of yearly working hours of all physicians working in medical care. Therefore, in an university hospital approximately 25% of the staff plan accounts for research and teaching.

Curriculum

Prognostic implications of neuropsychological test performance for surgical treatment of epilepsy.

Surgical treatment of epilepsy is undertaken on the basis of prognostically favorable clinical and laboratory data. Analysis of neuropsychological test data obtained preoperatively and postoperatively from 14 surgically treated patients indicates that specific measures of neuropsychological test performance may provide prognostic information aside from the utility of this testing for lateralization and localization. An impairment Index which is derived from the extensive test battery was related to change of seizure frequency. The groups of patients which have an improved or seizure-free status postoperatively also have the least preoperative neuropsychological impairment. The group of patients which did not show improvement of seizure frequency had a younger mean age at onset of seizures (x = 6.7 years), while the group which was rendered seizure free had a later age at onset (x = 17.2 years). There was no relationship for the duration of seizures prior to surgery and the outcome following surgery.

Adolescent

Biomechanical performance of ophthalmic surgical needles.

The mechanical performance of ophthalmic surgical needles is studied. Standard biomechanical tests, devised to evaluate the performance of ophthalmic surgical needles, are presented. Four comparable groups of ophthalmic surgical needles were selected from two different manufacturers for these biomechanical studies. The results of this testing demonstrate that needle point geometry and needle composition are important determinants of needle performance. When comparable size needles were evaluated, the biomechanical performance of the recently introduced CS160-6 ophthalmic needle (Ethicon, Inc) was superior to the AU-5, CU-5, and SU-5 needles (Alcon, Inc). Whereas the development of these biomechanical tests has allowed the evaluation of these ophthalmic needles, these same tests can be used to assess the performance of other new ophthalmic surgical needles.

Alloys

New technology in U.S. Army health care: the role of laparoscopic cholecystectomy.

In the near future, laparoscopic cholecystectomy could become one of the most frequently performed surgical procedures in U.S. military hospitals. To determine the best way to implement this new technology in the U.S. Army Health Services Command (HSC), we have assessed the safety, efficacy, and health consequences of laparoscopic cholecystectomy. Approximately 2,800 open cholecystectomies are performed annually in HSC hospitals, 11% of them on active duty personnel. If cholecystectomies were performed using laparoscopic surgical techniques on active duty patients who meet currently accepted indications, 3,360 personnel duty days lost to convalescence and 7,048 days of limited duty (time on physical profiles) would be recouped. Applying the procedure to other beneficiaries (dependents and retired service members) would result in a potential annual savings of 11,000 hospital bed days. If implemented using stringent criteria for training and certification, these savings could be achieved with no increase in patient morbidity or mortality and with significant improvement in patient outcome.

California

Rounded atelectasis with pleuritis: diagnosis and surgical treatment.

A 73-year-old male was admitted with a large rounded atelectasis with pleural effusion. The involved lung was refilled with air as soon as surgical decortication of the thickened visceral pleura covering it was performed. Surgical treatment is believed to be necessary when a large rounded atelectasis with pleural effusion persists for a long time, or when malignancy is not completely excluded.

Aged

Surgical repair of congenital colobomas.

Congenital colobomas usually occur as full-thickness defects of the medial third of the upper lid and are commonly associated with a benign dermoid at the apex. Exposure keratopathy and corneal trauma are rare; however, it can be prevented with the Expo Bandage--Bubble (Fig 18). Periodic examinations should also be performed. Surgical resonstruction should be performed at approximately 3 to 6 months of age and primary closure should be attempted initially. Lateral cantholysis, lid-sharing surgery, and external levator resection may be required to correct the residual deformity.

Abnormalities, Multiple

Urinary stress incontinence: differential diagnosis, pathophysiology, and management.

It is appropriate to introduce this review of the subject of urinary stress incontinence with a discussion of other disorders that may produce abdnormal urinary leakage,at times even stimulating true anatomic stress incontinence. It is obviously important to correctly identify patients with these other conditions and not perform surgical procedures unlikely to relieve their symptoms. Thereafter, the underlying pathophysiology of stress incontinence is considered in detail, since its fundamental understanding serves as the basis for both accurate diagnosis and proper selection and effective execution of the operations designed to correct true anatomic stress incontinence. A final section on patient management covers choice of the optimal surgical procedure for each individual patient, end results that should be achievable by proper selection and performance of the various operations, and a descriotion of some of the technical details that seem particularly helpful in carrying out the three principal types of surgical procedres currently in use.

Adult

[Ultrasonic methods of diagnosis of late complications after reconstructive surgery of the aorta and major arteries of the lower limbs].

Long-standing results were studied in 587 patients who sustained reconstructive vascular surgeries when aged under 16 years (the average age was 6 years and 4 months). Out of them 141 patients faced the necessity of repeated surgeries: in 115 (81.6%) patients the extremity function was preserved, in 19 (13.5%) a repeated amputation was performed, 7 patients (4.9%) expired. All those operated on had been actively followed up with the use of periodical instrumental investigation which included dopplerography and ultrasonic angiography. High significance of ultrasonic technique was proved as the use of it permitted one to detect late complications on the early stages of their development and perform surgical corrections before the development of life-threatening complications. Therefore repeated preventive surgeries were performed in 53 patients, 52 of them were a success. Repeated amputations were performed in 1 patient. All those operated on survived.

Adolescent

[Disorders of cardiac rhythm and conductivity after radical correction of tetralogy of Fallot in young children].

Analysis of electrocardiograms in 55 children who underwent operation for Fallot's tetralogy at early age showed that the frequency and severity of postoperative disorders of rhythm and conductivity were determined by the degree of trauma inflicted by the used surgical techniques. Data obtained in the early and late-term postoperative periods confirm the expediency of performing surgical correction of the anomaly as early as possible by means of surgical methods which cause little injury. The results of the study are recommended for use in choosing the surgical tactics, for functional appraisal of the operative results.

Arrhythmias, Cardiac

Decisions to hospitalize and operate: a socioeconomic perspective in an urban state.

Rates of hospital discharges for selected surgical procedures and some medical conditions were compared by socioeconomic status (SES) of patients for all 1972 hospital discharges from the 13 voluntary general hospitals located in Rhode Island. Socioeconomic status was determined by scoring the census tract of patient residence with such variables as median family income, housing status, etc. Many frequently performed surgical procedures had similar rates for the high, middle, low, and poverty socioeconomic groups. Procedures performed more frequently on the poverty than on the high SES group were tonsillectomy and upper gastrointestinal, heart, hemorrhoid, and cataract procedures. Dental procedures were performed more frequently on the high SES group. The over-all rate of hospital admissions showed a steady decline from the rate of 156 per 1,000 for the poverty census tracts to 104 for the high SES census tracts. This trend was reflected in the admission rates for several conditions requiring primary medical management, such as infections, diabetes, and skin problems. The population-based frame of reference used in this study can be a useful tool for raising pertinent questions for both professional standards review organizations and health planning groups.

Adolescent

Surgical curability and prognosis for standard versus extended resection for T1 carcinoma of the pancreas.

The prognosis of 185 patients who underwent surgical resection of small carcinomas of less than 2.0 centimeters (T1) of the pancreas in whom either standard or extended resection was used was analyzed. Pancreatic resection was performed upon 98.3 percent of the patients who were more than 49 years old. The location of the tumor was the head of the pancreas in 83.4 percent of the patients, the body of the pancreas in 13.2 percent and the tail of the pancreas in 3.3 percent. Tumor staging revealed 42.9 percent in stage I and the remainder in advanced stage, that is 33.1 percent stage II, 18.8 percent stage III and 5.1 percent stage IV. When standard resection was performed, surgical cure rates were more than 80 percent in stage I, II and III, but in stage IV, it was only 16.6 percent. After extended resection, the surgical cure rates increased even in stage IV (100 percent). There were no significant differences in the overall postoperative cumulative survival rates between standard and extended operation. In stage II, however, a significant better survival rate was observed after extended resection than after standard resection.

Adult