Who said medical school isn't all fun and games?
Italian researchers had 21 resident surgeons play video games on the Nintendo Wii for one hour every day for a month, and found that they performed significantly better on a complicated surgery than residents who didn't go through video game training.
The residents performed a laparoscopy, or keyhole surgery, which involves inserting tiny video cameras into your body so surgeons can know where to operate without having to make a large incision.
Laparoscopies decrease the risk of infection and reduce recovery time after the surgery, but can be difficult for new surgeons who are not used to relating their hand movements during an operation to a video monitor. Compared to open surgery, laparoscopy involves a limited range of motion of instruments and loss of depth perception.
Researchers at the University of Rome decided to help trainee surgeons boost their three-dimensional hand-eye coordination for surgery with Nintendo Wii video games.
"You have to move in a three-dimensional space but you have a two-dimensional image on your screen," said Dr. Gregorio Patrizi, professor at the University of Rome Medical School.
An earlier 2007 American study conducted at Beth Israel Medical Center in New York City showed that playing video games can hone surgeons' laparoscopic surgery skills, but it was a survey of video game habits, not an actual trial.
This Roman study, which was published in the journal PLOS One on February 27, is one of the first trials in which surgeons are given a video-game-playing routine and compared to a control group.
The resident surgeons in the study played three Nintendo Wii games - Wii Tennis, Wii Table Tennis, and High Altitude Battle, which involves shooting balloons from an aircraft. The games were chosen because they all require surgery skills like strong hand-eye coordination, movement precision, depth perception, and 3-D spatial visualization.
The surgical skills of both control and video-game-playing surgeons were tested before and after the month-long Wii training period on a laparoscopy simulator.
After a month of sticking to the Wii video game regimen (or not), the residents performed a simulated keyhole surgery. The Wii-playing surgeons showed significantly better surgery skills than the residents in the control group - and had a much more fun preparing.
"The differences in outcomes between the two groups were far beyond our expectations," Dr. Patrizi told NBC News. "What surprised us the most was that almost all the results were clearly statistically significant, even in complex procedures like virtual cholecystectomy,"
Patrizi told NPR that despite the study's obvious public relations boost for the Nintendo Wii, the Nintendo video game company had nothing to do with it. The team received no outside funding to conduct the trial, and Nintendo was unaware of the surgery study's existence.
A Nintendo spokeswoman said that the company is "thrilled to hear" that the Wii might aid surgery. The video game console was intended for entertainment and education, but the creators never imagined it could save lives. "Did we think that the Wii would improve the performance of surgeons?" she writes. "No."
The Wii video games were helpful for surgery because of the console's unique motion-sensing controls.
"The problem in laparoscopy (real and virtual) is that you have to move in a 3-D space with a 2-D view," Patrizi said to NBC News. "The Nintendo Wii is a video-game console with a wireless controller able to detect movement in three dimensions. Thanks to this controller, the gamers can play using physical gestures while traditional video-games require the player to press a button or to move a joystick. Therefore the improvement is based on the fact that the Nintendo Wii, like others recent consoles, provides 3-D video games and accordingly enhances visual attention, depth perception and movement coordination. On the other hand, the group who did not train on the Wii improved mostly according to the familiarization with the simulator."
Dr. Brant Oelschlager, chief of the University of Washington's Center for Videoendoscopic Surgery, understands how the Wii video game console might be helpful to new surgeons.
"There's probably a lot of overlap in that bit of learning," he told NPR. "Both are very unnatural environments to the novice."
Oelschlager pointed out that the Nintendo Wii video games would likely benefit only inexperienced surgeons in improving their surgery skills. "I'm skeptical that at an advanced level that would help the surgeon become better," he said. "At some point, it starts to have diminishing returns and you have to gain the rest of your skills in a real patient."
The authors of the study hope that the Nintendo Wii and other motion-sensing video game consoles like the Microsoft Kinect could be used to cheaply supplement surgical training.
They expect that, even if hospitals do not adopt the game consoles to replace expensive laparoscopy surgery simulators, younger surgeons can practice on their own at home in preparation for the real thing.
Published by Medicaldaily.com