Leveraging Virtual Reality and Haptics to Teach Surgical Skills: A Usability Study on Retropubic Midurethral Slings

Traditional methods to learn soft-tissue surgical procedures rely on cadaver labs or patient-based learning, which are costly and geographically limited, and raise ethical questions. Virtual reality (VR) with haptic feedback offers a scalable alternative, but most current platforms emphasize bone-based rather than soft-tissue procedures learned by feel. We developed a VR+haptic simulation for preoperative training of retropubic midurethral sling (MUS) surgery. This study examines the usability of this platform with thirteen expert urogynecologic surgeons and subsequently makes improvements (e.g., in haptics) to evaluate the platform with twelve trainees based on the NASA Task Load Index for workload and a UTAUT-informed usability survey. Objective performance scores were recorded as participants completed up to four levels of increasing realism and difficulty, starting with a transparent body and a reference surgical trajectory. Trainees reported high usability, immersion, and engagement. Experts rated the platform as valuable for sling training and skill assessment. NASA-TLX results indicated low physical and temporal demand, low mental demand and frustration, and moderate effort. These findings suggest that SurgicalEd VR is acceptable and has appropriate workload characteristics for surgical education. Future studies could examine how using VR+ haptic training improves intraoperative performance.