J.P.W. Greve
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2 records found
1
Objective: To systematically evaluate the economic impact of disposable versus reusable instruments in minimally invasive surgery (MIS), and to summarize the limited available evidence on environmental impact. Background: The increasing use of disposable instruments in MIS has raised concerns regarding healthcare costs and environmental sustainability. While reusable instruments may reduce per-procedure costs and waste, their economic and environmental performance is influenced by procedure type, workflow, and reprocessing requirements. Evidence integrating these factors across surgical specialties remains limited. Methods: A systematic review was conducted in accordance with PRISMA guidelines. Studies published since 2014 comparing disposable and reusable instruments in MIS were identified using predefined PICOS criteria. Data extraction focused on cost components, including instrument costs, sterilization, operating room time, and total procedural costs. Environmental outcomes were recorded when available. Results: Nine studies encompassing 4,724 procedures across multiple surgical specialties met inclusion criteria. In general surgery, reusable instruments were consistently associated with lower per-procedure costs, with reported savings ranging from $16 to $388. In selected subspecialties, including gynecology, thoracic surgery, and spinal surgery, disposable instruments were associated with reduced operative time, indirectly lowering total costs in specific settings. Only one included study directly assessed environmental impact, providing limited, low-level evidence that reusable instruments may confer environmental benefit primarily when used repeatedly. Conclusion: Reusable instruments appear to be associated with lower per-procedure costs in general surgery, while disposable instruments may offer context-specific economic advantages in selected subspecialties. Conclusions regarding environmental impact are limited by the scarcity of primary data. Future studies incorporating standardized cost definitions and robust environmental assessments, including life-cycle analyses, are needed to support evidence-based and sustainable instrument selection in MIS.
Virtual reality (VR) training is increasingly explored for fine motor skill development in children, yet little is known about its feasibility in primary school-aged populations. Understanding differences in motor learning across developmental stages may guide optimal timing for introducing simulation-based training.
Methods
Primary school children were recruited and stratified into lower, middle, and upper primary groups. Participants completed a laparoscopic training task on the ADLAP box trainer. Performance was assessed using objective motion analysis parameters, including task time, instrument path length, collisions, and working volume.
Results
Thirty-five children (N = 35) completed the task (11 lower, 12 middle, 12 upper primary). Performance improved significantly with age. Total task time decreased from 201,147 ms in lower primary to 97,155 ms in upper primary (p < 0.001). Similar age-dependent improvements were observed in instrument path length (p ≤ 0.007) and collisions (p ≤ 0.014). Working volume decreased with age, although differences did not reach significance.
Conclusion
Primary school children can successfully perform laparoscopic training tasks, with clear performance gains across age groups. These findings support the feasibility of VR and box trainer-based approaches for assessing motor skills in children, and highlight the potential of simulation to inform early skill development and educational strategies. ...
Virtual reality (VR) training is increasingly explored for fine motor skill development in children, yet little is known about its feasibility in primary school-aged populations. Understanding differences in motor learning across developmental stages may guide optimal timing for introducing simulation-based training.
Methods
Primary school children were recruited and stratified into lower, middle, and upper primary groups. Participants completed a laparoscopic training task on the ADLAP box trainer. Performance was assessed using objective motion analysis parameters, including task time, instrument path length, collisions, and working volume.
Results
Thirty-five children (N = 35) completed the task (11 lower, 12 middle, 12 upper primary). Performance improved significantly with age. Total task time decreased from 201,147 ms in lower primary to 97,155 ms in upper primary (p < 0.001). Similar age-dependent improvements were observed in instrument path length (p ≤ 0.007) and collisions (p ≤ 0.014). Working volume decreased with age, although differences did not reach significance.
Conclusion
Primary school children can successfully perform laparoscopic training tasks, with clear performance gains across age groups. These findings support the feasibility of VR and box trainer-based approaches for assessing motor skills in children, and highlight the potential of simulation to inform early skill development and educational strategies.