Acquisition of fundamental laparoscopic skills: is a box really as good as a virtual reality trainer?

Abstract

Background: Laparoscopic surgery requires working in a three-dimensional environment with a two-dimensional view. Skills such as depth perception, hand to eye co-ordination and bimanual manipulation are crucial to its efficacy.

Aim: To compare the efficiency of training in laparoscopic skills on a VR simulator with a traditional box trainer.

Method: Twenty medical students were recruited. An initial training session on the relevant anatomy and steps of a laparoscopic cholecystectomy was given. Baseline skills were recorded using a pre-training laparoscopic cholecystectomy on the VR trainer. Parameters measured were: (1) total time taken (mins); (2) number of movements right and left instrument; (3) path length (cms) of right and left instrument was recorded. Ten students trained on a VR simulator, and ten on a box trainer, for three hours each. The box trainer group exercises were based on the Royal College of Surgeons core laparoscopic skills course, and the VR trainer exercises were based on the Simbionix LapMentor basic skills tasks. Following this both groups were reassessed by a laparoscopic cholecystectomy on the VR trainer.

Results: Both groups showed improvement in all measured parameters. A student T-test at 95% confidence interval showed no statistically significant difference between the two groups pre and post training.

Conclusion: Both the VR and box trainer are effective in the acquisition of laparoscopic skills.