The Experts below are selected from a list of 303 Experts worldwide ranked by ideXlab platform
Jette Led Soerensen - One of the best experts on this subject based on the ideXlab platform.
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the efficacy of virtual reality simulation training in Laparoscopy a systematic review of randomized trials
Acta Obstetricia et Gynecologica Scandinavica, 2012Co-Authors: Christian Rifbjerg Larsen, Jeanett Oestergaard, Bent Ottesen, Jette Led SoerensenAbstract:Background. Virtual reality (VR) simulators for surgical training might possess the properties needed for basic training in Laparoscopy. Evidence for training efficacy of VR has been investigated by research of varying quality over the past decade. Objective. To review randomized controlled trials regarding VR training efficacy compared with traditional or no training, with outcome measured as surgical performance in humans or animals. Data sources. In June 2011 Medline, Embase, the Cochrane Central Register of Controlled Trials, Web of Science and Google Scholar were searched using the following medical subject headings (MeSh) terms: Laparoscopy/standards, Computing methodologies, Programmed instruction, Surgical procedures, Operative, and the following free text terms: Virtual real* OR simulat* AND Laparoscop* OR train* Limits: Controlled trials. Study eligibility criteria. All randomized controlled trials investigating the effect of VR training in Laparoscopy, with outcome measured as surgical performance. Methods. A total of 98 studies were screened, 26 selected and 12 included, with a total of 241 participants. Results. Operation time was reduced by 17–50% by VR training, depending on simulator type and training principles. Proficiency-based training appeared superior to training based on fixed time or fixed numbers of repetition. Simulators offering training for complete operative procedures came out as more efficient than simulators offering only basic skills training. Conclusions. Skills in laparoscopic surgery can be increased by proficiency-based procedural VR simulator training. There is substantial evidence (grade IA – IIB) to support the use of VR simulators in laparoscopic training.
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The efficacy of virtual reality simulation training in Laparoscopy: A systematic review of randomized trials
Acta Obstetricia et Gynecologica Scandinavica, 2012Co-Authors: Christian Rifbjerg Larsen, Bent S. Ottesen, Jeanett Oestergaard, Jette Led SoerensenAbstract:BACKGROUND: Virtual reality (VR) simulators for surgical training might possess the properties needed for basic training in Laparoscopy. Evidence for training efficacy of VR has been investigated by research of varying quality over the past decade.\n\nOBJECTIVE: To review randomized controlled trials regarding VR training efficacy compared with traditional or no training, with outcome measured as surgical performance in humans or animals.\n\nDATA SOURCES: In June 2011 Medline, Embase, the Cochrane Central Register of Controlled Trials, Web of Science and Google Scholar were searched using the following medical subject headings (MeSh) terms: Laparoscopy/standards, Computing methodologies, Programmed instruction, Surgical procedures, Operative, and the following free text terms: Virtual real* OR simulat* AND Laparoscop* OR train* Limits: Controlled trials.\n\nSTUDY ELIGIBILITY CRITERIA: All randomized controlled trials investigating the effect of VR training in Laparoscopy, with outcome measured as surgical performance.\n\nMETHODS: A total of 98 studies were screened, 26 selected and 12 included, with a total of 241 participants.\n\nRESULTS: Operation time was reduced by 17-50% by VR training, depending on simulator type and training principles. Proficiency-based training appeared superior to training based on fixed time or fixed numbers of repetition. Simulators offering training for complete operative procedures came out as more efficient than simulators offering only basic skills training.\n\nCONCLUSIONS: Skills in laparoscopic surgery can be increased by proficiency-based procedural VR simulator training. There is substantial evidence (grade IA - IIB) to support the use of VR simulators in laparoscopic training.
Sudarshan K. Sharma - One of the best experts on this subject based on the ideXlab platform.
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recurrence and survival after random assignment to Laparoscopy versus laparotomy for comprehensive surgical staging of uterine cancer gynecologic oncology group lap2 study
Journal of Clinical Oncology, 2012Co-Authors: Joan L Walker, Marion R Piedmonte, Scott M. Eisenkop, Nick M Spirtos, Richard R Barakat, John B. Schlaerth, Robert S Mannel, Michael L Pearl, Sudarshan K. SharmaAbstract:Purpose The primary objective was to establish noninferiority of Laparoscopy compared with laparotomy for recurrence after surgical staging of uterine cancer. Patients and Methods Patients with clinical stages I to IIA disease were randomly allocated (two to one) to Laparoscopy (n = 1,696) versus laparotomy (n = 920) for hysterectomy, salpingo-oophorectomy, pelvic cytology, and pelvic and para-aortic lymphadenectomy. The primary study end point was noninferiority of recurrence-free interval defined as no more than a 40% increase in the risk of recurrence with Laparoscopy compared with laparotomy. Results With a median follow-up time of 59 months for 2,181 patients still alive, there were 309 recurrences (210 Laparoscopy; 99 laparotomy) and 350 deaths (229 Laparoscopy; 121 laparotomy). The estimated hazard ratio for Laparoscopy relative to laparotomy was 1.14 (90% lower bound, 0.92; 95% upper bound, 1.46), falling short of the protocol-specified definition of noninferiority. However, the actual recurrence ...
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Laparoscopy compared with laparotomy for comprehensive surgical staging of uterine cancer gynecologic oncology group study lap2
Obstetrical & Gynecological Survey, 2010Co-Authors: Joan L Walker, Gregory Spiegel, Richard Barakat, Marion R Piedmonte, Scott M. Eisenkop, Nick M Spirtos, John B. Schlaerth, Robert S Mannel, Michael L Pearl, Sudarshan K. SharmaAbstract:The conventional method for comprehensive surgical staging in endometrial cancer is open laparotomy. Since the 1990s, minimally invasive Laparoscopy has been investigated for comprehensive surgical staging in endometrial cancer in small efficacy and safety studies. This prospective randomized trial was designed to compare use of laparotomy and Laparoscopy for complete comprehensive surgical staging of uterine cancer. Between 1996 and 2005, a total of 2616 patients with clinical stage I to IIA uterine cancer were randomly assigned —920 to open laparotomy and 1696 to Laparoscopy. The procedures undertaken with both methods included hysterectomy, salpingo-oophorectomy, pelvic and paraaortic lymphadenectomy, and peritoneal cytology. The primary study end points were short-term (6 weeks) surgical outcomes, including recurrence-free survival, intraoperative complications, Laparoscopy conversion to laparotomy, length of hospital stay, operative time, patient-reported quality of life, and sites of recurrence. The data was adjusted for patient age, race/ethnicity, body mass index, and performance status. Laparoscopy was completed without conversion to open laparotomy in 1248 patients (74.2%). Conversion to laparotomy was required in 434 participants (25.8%). Reasons for conversion included poor exposure in 246 patients (14.6%), metastatic cancer in 69 patients (4.1%), excessive bleeding in 49 patients (2.9%), and other causes in 70 patients (4.2%). Fewer moderate-to-severe postoperative adverse events occurred with Laparoscopy compared to laparotomy (14% versus 21%; P < 0.001). Although the median operative time was shorter for open laparotomy than Laparoscopy (130 versus 204 minutes; P < 0.001), there was no statistical difference between the 2 treatment groups in rates of intraoperative complications (laparotomy: 8% versus Laparoscopy: 10%; P = 0.106). The percentage of patients requiring more than 2 days of hospitalization after surgery was significantly lower in patients receiving Laparoscopy compared with laparotomy (52% versus 94%; P < 0.001). Both pelvic and paraaortic nodes were not removed in 4% of laparotomy patients and 8% of Laparoscopy patients (P < 0.0001). The proportion of laparotomy and Laparoscopy patients found to have advanced surgical stage (FIGO stage IIIA, IIIC, or IV) was not significantly different (17% for each method; P = 0.851). The investigators conclude from these findings that laparoscopic comprehensive surgical staging for uterine cancer is feasible. Compared to laparotomy, short-term outcomes of Laparoscopy show fewer postoperative complications, and shorter hospital stay without increased intraoperative injuries.
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Laparoscopy compared with laparotomy for comprehensive surgical staging of uterine cancer gynecologic oncology group study lap2
Journal of Clinical Oncology, 2009Co-Authors: Joan L Walker, Gregory Spiegel, Richard Barakat, Marion R Piedmonte, Scott M. Eisenkop, Nick M Spirtos, John B. Schlaerth, Robert S Mannel, Michael L Pearl, Sudarshan K. SharmaAbstract:Purpose The objective was to compare Laparoscopy versus laparotomy for comprehensive surgical staging of uterine cancer. Patients and Methods Patients with clinical stage I to IIA uterine cancer were randomly assigned to Laparoscopy (n = 1,696) or open laparotomy (n = 920), including hysterectomy, salpingo-oophorectomy, pelvic cytology, and pelvic and para-aortic lymphadenectomy. The main study end points were 6-week morbidity and mortality, hospital length of stay, conversion from Laparoscopy to laparotomy, recurrence-free survival, site of recurrence, and patient-reported quality-of-life outcomes. Results Laparoscopy was initiated in 1,682 patients and completed without conversion in 1,248 patients (74.2%). Conversion from Laparoscopy to laparotomy was secondary to poor visibility in 246 patients (14.6%), metastatic cancer in 69 patients (4.1%), bleeding in 49 patients (2.9%), and other cause in 70 patients (4.2%). Laparoscopy had fewer moderate to severe postoperative adverse events than laparotomy (14...
Christian Rifbjerg Larsen - One of the best experts on this subject based on the ideXlab platform.
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the efficacy of virtual reality simulation training in Laparoscopy a systematic review of randomized trials
Acta Obstetricia et Gynecologica Scandinavica, 2012Co-Authors: Christian Rifbjerg Larsen, Jeanett Oestergaard, Bent Ottesen, Jette Led SoerensenAbstract:Background. Virtual reality (VR) simulators for surgical training might possess the properties needed for basic training in Laparoscopy. Evidence for training efficacy of VR has been investigated by research of varying quality over the past decade. Objective. To review randomized controlled trials regarding VR training efficacy compared with traditional or no training, with outcome measured as surgical performance in humans or animals. Data sources. In June 2011 Medline, Embase, the Cochrane Central Register of Controlled Trials, Web of Science and Google Scholar were searched using the following medical subject headings (MeSh) terms: Laparoscopy/standards, Computing methodologies, Programmed instruction, Surgical procedures, Operative, and the following free text terms: Virtual real* OR simulat* AND Laparoscop* OR train* Limits: Controlled trials. Study eligibility criteria. All randomized controlled trials investigating the effect of VR training in Laparoscopy, with outcome measured as surgical performance. Methods. A total of 98 studies were screened, 26 selected and 12 included, with a total of 241 participants. Results. Operation time was reduced by 17–50% by VR training, depending on simulator type and training principles. Proficiency-based training appeared superior to training based on fixed time or fixed numbers of repetition. Simulators offering training for complete operative procedures came out as more efficient than simulators offering only basic skills training. Conclusions. Skills in laparoscopic surgery can be increased by proficiency-based procedural VR simulator training. There is substantial evidence (grade IA – IIB) to support the use of VR simulators in laparoscopic training.
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The efficacy of virtual reality simulation training in Laparoscopy: A systematic review of randomized trials
Acta Obstetricia et Gynecologica Scandinavica, 2012Co-Authors: Christian Rifbjerg Larsen, Bent S. Ottesen, Jeanett Oestergaard, Jette Led SoerensenAbstract:BACKGROUND: Virtual reality (VR) simulators for surgical training might possess the properties needed for basic training in Laparoscopy. Evidence for training efficacy of VR has been investigated by research of varying quality over the past decade.\n\nOBJECTIVE: To review randomized controlled trials regarding VR training efficacy compared with traditional or no training, with outcome measured as surgical performance in humans or animals.\n\nDATA SOURCES: In June 2011 Medline, Embase, the Cochrane Central Register of Controlled Trials, Web of Science and Google Scholar were searched using the following medical subject headings (MeSh) terms: Laparoscopy/standards, Computing methodologies, Programmed instruction, Surgical procedures, Operative, and the following free text terms: Virtual real* OR simulat* AND Laparoscop* OR train* Limits: Controlled trials.\n\nSTUDY ELIGIBILITY CRITERIA: All randomized controlled trials investigating the effect of VR training in Laparoscopy, with outcome measured as surgical performance.\n\nMETHODS: A total of 98 studies were screened, 26 selected and 12 included, with a total of 241 participants.\n\nRESULTS: Operation time was reduced by 17-50% by VR training, depending on simulator type and training principles. Proficiency-based training appeared superior to training based on fixed time or fixed numbers of repetition. Simulators offering training for complete operative procedures came out as more efficient than simulators offering only basic skills training.\n\nCONCLUSIONS: Skills in laparoscopic surgery can be increased by proficiency-based procedural VR simulator training. There is substantial evidence (grade IA - IIB) to support the use of VR simulators in laparoscopic training.
Joan L Walker - One of the best experts on this subject based on the ideXlab platform.
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recurrence and survival after random assignment to Laparoscopy versus laparotomy for comprehensive surgical staging of uterine cancer gynecologic oncology group lap2 study
Journal of Clinical Oncology, 2012Co-Authors: Joan L Walker, Marion R Piedmonte, Scott M. Eisenkop, Nick M Spirtos, Richard R Barakat, John B. Schlaerth, Robert S Mannel, Michael L Pearl, Sudarshan K. SharmaAbstract:Purpose The primary objective was to establish noninferiority of Laparoscopy compared with laparotomy for recurrence after surgical staging of uterine cancer. Patients and Methods Patients with clinical stages I to IIA disease were randomly allocated (two to one) to Laparoscopy (n = 1,696) versus laparotomy (n = 920) for hysterectomy, salpingo-oophorectomy, pelvic cytology, and pelvic and para-aortic lymphadenectomy. The primary study end point was noninferiority of recurrence-free interval defined as no more than a 40% increase in the risk of recurrence with Laparoscopy compared with laparotomy. Results With a median follow-up time of 59 months for 2,181 patients still alive, there were 309 recurrences (210 Laparoscopy; 99 laparotomy) and 350 deaths (229 Laparoscopy; 121 laparotomy). The estimated hazard ratio for Laparoscopy relative to laparotomy was 1.14 (90% lower bound, 0.92; 95% upper bound, 1.46), falling short of the protocol-specified definition of noninferiority. However, the actual recurrence ...
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Laparoscopy compared with laparotomy for comprehensive surgical staging of uterine cancer gynecologic oncology group study lap2
Obstetrical & Gynecological Survey, 2010Co-Authors: Joan L Walker, Gregory Spiegel, Richard Barakat, Marion R Piedmonte, Scott M. Eisenkop, Nick M Spirtos, John B. Schlaerth, Robert S Mannel, Michael L Pearl, Sudarshan K. SharmaAbstract:The conventional method for comprehensive surgical staging in endometrial cancer is open laparotomy. Since the 1990s, minimally invasive Laparoscopy has been investigated for comprehensive surgical staging in endometrial cancer in small efficacy and safety studies. This prospective randomized trial was designed to compare use of laparotomy and Laparoscopy for complete comprehensive surgical staging of uterine cancer. Between 1996 and 2005, a total of 2616 patients with clinical stage I to IIA uterine cancer were randomly assigned —920 to open laparotomy and 1696 to Laparoscopy. The procedures undertaken with both methods included hysterectomy, salpingo-oophorectomy, pelvic and paraaortic lymphadenectomy, and peritoneal cytology. The primary study end points were short-term (6 weeks) surgical outcomes, including recurrence-free survival, intraoperative complications, Laparoscopy conversion to laparotomy, length of hospital stay, operative time, patient-reported quality of life, and sites of recurrence. The data was adjusted for patient age, race/ethnicity, body mass index, and performance status. Laparoscopy was completed without conversion to open laparotomy in 1248 patients (74.2%). Conversion to laparotomy was required in 434 participants (25.8%). Reasons for conversion included poor exposure in 246 patients (14.6%), metastatic cancer in 69 patients (4.1%), excessive bleeding in 49 patients (2.9%), and other causes in 70 patients (4.2%). Fewer moderate-to-severe postoperative adverse events occurred with Laparoscopy compared to laparotomy (14% versus 21%; P < 0.001). Although the median operative time was shorter for open laparotomy than Laparoscopy (130 versus 204 minutes; P < 0.001), there was no statistical difference between the 2 treatment groups in rates of intraoperative complications (laparotomy: 8% versus Laparoscopy: 10%; P = 0.106). The percentage of patients requiring more than 2 days of hospitalization after surgery was significantly lower in patients receiving Laparoscopy compared with laparotomy (52% versus 94%; P < 0.001). Both pelvic and paraaortic nodes were not removed in 4% of laparotomy patients and 8% of Laparoscopy patients (P < 0.0001). The proportion of laparotomy and Laparoscopy patients found to have advanced surgical stage (FIGO stage IIIA, IIIC, or IV) was not significantly different (17% for each method; P = 0.851). The investigators conclude from these findings that laparoscopic comprehensive surgical staging for uterine cancer is feasible. Compared to laparotomy, short-term outcomes of Laparoscopy show fewer postoperative complications, and shorter hospital stay without increased intraoperative injuries.
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Laparoscopy compared with laparotomy for comprehensive surgical staging of uterine cancer gynecologic oncology group study lap2
Journal of Clinical Oncology, 2009Co-Authors: Joan L Walker, Gregory Spiegel, Richard Barakat, Marion R Piedmonte, Scott M. Eisenkop, Nick M Spirtos, John B. Schlaerth, Robert S Mannel, Michael L Pearl, Sudarshan K. SharmaAbstract:Purpose The objective was to compare Laparoscopy versus laparotomy for comprehensive surgical staging of uterine cancer. Patients and Methods Patients with clinical stage I to IIA uterine cancer were randomly assigned to Laparoscopy (n = 1,696) or open laparotomy (n = 920), including hysterectomy, salpingo-oophorectomy, pelvic cytology, and pelvic and para-aortic lymphadenectomy. The main study end points were 6-week morbidity and mortality, hospital length of stay, conversion from Laparoscopy to laparotomy, recurrence-free survival, site of recurrence, and patient-reported quality-of-life outcomes. Results Laparoscopy was initiated in 1,682 patients and completed without conversion in 1,248 patients (74.2%). Conversion from Laparoscopy to laparotomy was secondary to poor visibility in 246 patients (14.6%), metastatic cancer in 69 patients (4.1%), bleeding in 49 patients (2.9%), and other cause in 70 patients (4.2%). Laparoscopy had fewer moderate to severe postoperative adverse events than laparotomy (14...
Jeanett Oestergaard - One of the best experts on this subject based on the ideXlab platform.
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the efficacy of virtual reality simulation training in Laparoscopy a systematic review of randomized trials
Acta Obstetricia et Gynecologica Scandinavica, 2012Co-Authors: Christian Rifbjerg Larsen, Jeanett Oestergaard, Bent Ottesen, Jette Led SoerensenAbstract:Background. Virtual reality (VR) simulators for surgical training might possess the properties needed for basic training in Laparoscopy. Evidence for training efficacy of VR has been investigated by research of varying quality over the past decade. Objective. To review randomized controlled trials regarding VR training efficacy compared with traditional or no training, with outcome measured as surgical performance in humans or animals. Data sources. In June 2011 Medline, Embase, the Cochrane Central Register of Controlled Trials, Web of Science and Google Scholar were searched using the following medical subject headings (MeSh) terms: Laparoscopy/standards, Computing methodologies, Programmed instruction, Surgical procedures, Operative, and the following free text terms: Virtual real* OR simulat* AND Laparoscop* OR train* Limits: Controlled trials. Study eligibility criteria. All randomized controlled trials investigating the effect of VR training in Laparoscopy, with outcome measured as surgical performance. Methods. A total of 98 studies were screened, 26 selected and 12 included, with a total of 241 participants. Results. Operation time was reduced by 17–50% by VR training, depending on simulator type and training principles. Proficiency-based training appeared superior to training based on fixed time or fixed numbers of repetition. Simulators offering training for complete operative procedures came out as more efficient than simulators offering only basic skills training. Conclusions. Skills in laparoscopic surgery can be increased by proficiency-based procedural VR simulator training. There is substantial evidence (grade IA – IIB) to support the use of VR simulators in laparoscopic training.
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The efficacy of virtual reality simulation training in Laparoscopy: A systematic review of randomized trials
Acta Obstetricia et Gynecologica Scandinavica, 2012Co-Authors: Christian Rifbjerg Larsen, Bent S. Ottesen, Jeanett Oestergaard, Jette Led SoerensenAbstract:BACKGROUND: Virtual reality (VR) simulators for surgical training might possess the properties needed for basic training in Laparoscopy. Evidence for training efficacy of VR has been investigated by research of varying quality over the past decade.\n\nOBJECTIVE: To review randomized controlled trials regarding VR training efficacy compared with traditional or no training, with outcome measured as surgical performance in humans or animals.\n\nDATA SOURCES: In June 2011 Medline, Embase, the Cochrane Central Register of Controlled Trials, Web of Science and Google Scholar were searched using the following medical subject headings (MeSh) terms: Laparoscopy/standards, Computing methodologies, Programmed instruction, Surgical procedures, Operative, and the following free text terms: Virtual real* OR simulat* AND Laparoscop* OR train* Limits: Controlled trials.\n\nSTUDY ELIGIBILITY CRITERIA: All randomized controlled trials investigating the effect of VR training in Laparoscopy, with outcome measured as surgical performance.\n\nMETHODS: A total of 98 studies were screened, 26 selected and 12 included, with a total of 241 participants.\n\nRESULTS: Operation time was reduced by 17-50% by VR training, depending on simulator type and training principles. Proficiency-based training appeared superior to training based on fixed time or fixed numbers of repetition. Simulators offering training for complete operative procedures came out as more efficient than simulators offering only basic skills training.\n\nCONCLUSIONS: Skills in laparoscopic surgery can be increased by proficiency-based procedural VR simulator training. There is substantial evidence (grade IA - IIB) to support the use of VR simulators in laparoscopic training.
