![]() Scalpels, tweezer and other small instruments are sometimes impossible to grasp. It can be a nightmare just to pick up a tool, let a long try to use it. But that’s not the way it actually works. Or it should feel like you’re bunching a scalpel betwixt your thumb and index finger to allow for precision slicing. You’d imagine it would feel like you’re wielding the hammer you’ll use to smash open a ribcage. With both control schemes, you’ll have to depress buttons on the controller to activate specific fingers – so holding something firmly in your hand requires the sort of squeezing you’d imagine would feel natural. ![]() Surgeon Simulator’s never been accuracy or precision, but the implementation of its controls in VR is often such an impediment that it can make the game wholly unplayable, detracting from its whimsy. Controls – whether you opt for the pair of wands, or a single DualShock 4 – are frankly horrible. Somehow, in translation, everything’s gone through to the wrong extreme. It should have been simple to translate Surgeon Simulator’s imprecise controls to VR, using the already sometimes wonky Move controllers to great effect. It’s not that the idea doesn’t translate well, rather just that it’s been implemented horribly. I’d though that operating on poor old Bob again, just within a VR world this time, would be a jolly good, terribly silly time. Doing mundane, rote tasks – the stuff people habitually call work – within virtual reality gives it a new life, and makes that sort of humdrum oddly enjoyable. It seems a natural fit for the platform, especially after playing games like Job Simulator. *Conclusions: We created a low-cost kidney transplant surgery simulator that can be incorporated in a transplant educational curriculum for trainees to learn and practice the time-sensitive vascular anastomoses without impacting patient outcomes.When I heard that the perpetually silly Surgeon simulator would be making its way to Virtual Reality platforms, I was excited. All surveyed trainees wished that they had access to the simulator prior to their first kidney transplant surgery and recommended its inclusion in their educational curriculum. Surveyed trainees with kidney transplant surgery experience gave a mean score of 95/100 when asked about the utility of the simulator to improve suturing speed, and a mean score of 90/100 on its utility to learn the operative steps. Two trainees work together on the simulator to perform and assist in the vascular anastomoses including clamping, venotomy, arteriotomy, suturing, following, and retraction (Figure 2). ![]() A kidney-shaped stress ball was modified with 1.27 x 4 cm, 0.64 x 4 cm, and 0.64 x 15 cm Penrose drains anteriorly, posteriorly, and inferiorly to replicate a kidney allograft with its renal vein, artery and ureter respectively (Figure 1). Plastic hooks attached to the box’s sidewall held under tension Penrose drains of 1.27 cm and 0.64 cm diameter to replicate the external iliac vein and artery respectively. *Results: A 35.9 x 19.4 x 12.4 cm plastic box was used to mimic the iliac fossa. Trainees (n=9) with kidney transplant surgery experience answered a 0-100 visual analog scale questionnaire about the educational utility of the simulator. *Methods: We searched for inexpensive materials to replicate the iliac fossa, vasculature, and kidney allograft. We built a low-cost kidney transplant surgery simulator for trainees to learn and practice the vascular anastomoses step and surveyed its educational utility. A time-sensitive step impacting outcomes is performance of the vascular anastomoses. ![]() Trainees are most involved in kidney transplant surgery. Simulation could overcome these challenges, but is underdeveloped in transplant surgery. *Purpose: Surgical skills education in transplant surgery is challenging as center-specific outcomes are scrutinized and trainees’ exposure to the sub-specialty is decreasing.
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