Abstract
Background
Laparoscopic surgery requires a different set of skills than traditional open surgery. The acquisition of basic laparoscopic skills may help novices when learning laparoscopic procedures. This study tested the hypothesis that the combination of virtual reality and box trainers leads to better basic laparoscopic skill acquisition than either method alone or no training.
Methods
A randomized control trial involving preclinical medical students with no prior operative experience was performed. The students were grouped according to four training methods: virtual reality training, inanimate box training, a combination of both, and no training (control). The pre- and posttraining scores for four skills in the porcine laboratory were the metrics chosen for this study.
Results
A total of 65 students participated in this study. There were no differences among any of the pretraining scores (p > 0.05). The posttraining times differed between the four groups. Post hoc analyses showed statistically significant differences (p < 0.05) between the participants trained with both trainers and the control subjects.
Conclusions
Our data demonstrate that the combination of virtual reality training and inanimate box training leads to better laparoscopic skill acquisition than either training method alone or no training at all. Optimal preclinical laparoscopic training should incorporate both virtual reality trainers and inanimate box trainers.
Similar content being viewed by others
References
Ali MR, Mowery Y, Kaplan B, DeMaria EJ (2002) Training the novice in laparoscopy. Surg Endosc 16: 1732–1736
Champion JK, Hunter J, Trus T, Laycock W (1996) Teaching basic video skills as an aid in laparoscopic suturing. Surg Endosc 10: 23–25
Derossis AM, Brothwell J, Sigman HH, Fried GM (1998) The effect of practice on performance in a laparoscopic simulator. Surg Endosc 12: 1117–1120
Faulkner H, Regehr G, Martin J, Reznick R (1996) Validation of an objective structured assessment of technical skill for surgical residents. Acad Med 71: 1363–1365
Figert PL, Park AE, Witzke DB, Schwartz RW (2001) Transfer of training in acquiring laparoscopic skills. J Am Coll Surg 193: 533–537
Gallagher AG, McClure N, McGuigan J, Crothers I, Browning J (1999) Virtual reality training in laparoscopic surgery: a preliminary assessment of minimally invasive surgical trainer virtual reality (MIST VR). Endoscopy 31: 310–313
Grantcharov TP, Kristiansen VB, Bendix J, Bardram L, Rosenberg J, Funch-Jensen P (2004) Randomized clinical trial of virtual reality simulation for laparoscopic skills training. Br J Surg 91: 146–150
Hamilton EC, Scott DJ, Fleming JB, Rege RV, Laycock R, Bergen PC, Tesfay ST, Jones DB (2002) Comparison of video trainer and virtual reality training systems on acquisition of laparoscopic skills. Surg Endosc 16: 406–411
Harold KL, Matthews BD, Backus CL, Pratt BL, Heniford BT (2002) Prospective randomized evaluation of surgical resident proficiency with laparoscopic suturing after course instruction. Surg Endosc 16: 1729–1731
Hasson HM, Kumari NV, Eekhout J (2001) Training simulator for developing laparoscopic skills. JSLS 5: 255–265
Madan AK, Frantzides CT (xxxx) Substituting virtual reality training for inanimate box trainers does not decrease laparoscopic skill acquisition. JSLS In Press
Madan AK, Frantzides CT, Park WC, Tebbit CL, Kumari NVA, O’Leary PJ (2005) Predicting baseline laparoscopic surgery skills. Surg Endosc 19: 101–103
Madan AK, Frantzides CT, Sasso L (2005) Laparoscopic baseline ability assessment by virtual reality. J Laparoendosc Adv Surg Tech A 15: 13–17
Madan AK, Frantizdes CT, Shervin N, Tebbit CL (2003) Assessment of individual hand performance in box trainers compared to virtual reality trainers. Am Surg 69: 1112–1114
Madan AK, Frantzides CT, Tebbit CL, Park WC, Kumari NVA, Shervin N (2004) Evaluation of specialized laparoscopic suturing and tying devices. JSLS 8: 191–193
Madan AK, Frantzides CT, Tebbit CL, Quiros RM (2005) Participant’s opinions of laparoscopic trainers during basic laparoscopic training courses. Am J Surg 189: 758–761
Madan AK, Frantzides CT, Tebbit CL, Shervin N, Quiros R (2005) Self-reported versus observed scores in laparoscopic skills training. Surg Endosc 19: 670–672
Martin JA, Regehr G, Reznick R, MacRae H, Murnaghan J, Hutchison C, Brown M (1997) Objective structured assessment of technical skill (OSATS) for surgical residents. Br J Surg 84: 273–278
Mori T, Hatano N, Maruyama S, Atomi Y (1998) Significance of “hands-on training” in laparoscopic surgery. Surg Endosc 12: 256–260
Munz Y, Kumar BD, Moorthy K, Bann S, Darzi A (2004) Laparoscopic virtual reality and box trainers: is one superior to the other? Surg Endosc 18: 485–494
Pearson AM, Gallagher AG, Rosser JC, Satava RM (2002) Evaluation of structured and quantitative training methods for teaching intracorporeal knot tying. Surg Endosc 16: 130–137
Peters JH, Fried GM, Swanstrom LL, Soper NJ, Sillin LF, Schirmer B, Hoffman K (2004) Development and validation of a comprehensive program of education and assessment of the basic fundamentals of laparoscopic surgery. Surgery 135: 21–27
Reznick R, Regehr G, MacRae H, Martin J, McCulloch W (1997) Testing technical skills via an innovative “bench station” examination. Am J Surg 173: 226–230
Rosser JC, Murayama M, Gabriel NH (2000) Minimally invasive surgical training solutions for the twenty-first century. Surg Clin North Am 80: 1607–1624
Rosser JC, Rosser LE, Savalgi RS (1998) Objective evaluation of a laparoscopic surgical skill program for residents and senior surgeons. Arch Surg 133: 657–661
Rosser JC, Rosser LE, Savalgi RS (1997) Skill acquisition and assessment for laparoscopic surgery. Arch Surg 132: 200–204
Scott DJ, Bergen PC, Rege RV, Laycock R, Tesfay ST, Valentine RJ, Euhus DM, Jeyarajah DR, Thompson WM, Jones DB (2000) Laparoscopic training on bench models: better and most cost effective than operating room experience? J Am Coll Surg 191: 272–283
Seymour NE, Gallagher AG, Roman SA, O’Brien MK, Bansal VK, Andersen DK, Satava RM (2002) Virtual reality training improves operating room performance: results of a randomized, double-blinded study. Ann Surg 236: 458–464
Youngblood PL, Srivastava S, Curet M, Heinrichs WL, Dev P, Wren SM (2005) Comparison of training on two laparoscopic simulators and assessment of skills transfer to surgical performance. J Am Coll Surg 200: 546–551
Acknowledgments
The authors acknowledge the technical assistance of Mrs. Courtney Bishop in the preparation of this article.
Author information
Authors and Affiliations
Corresponding author
Additional information
Presented in part at the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) annual meeting, March 2004, Denver, CO
Rights and permissions
About this article
Cite this article
Madan, A.K., Frantzides, C.T. Prospective randomized controlled trial of laparoscopic trainers for basic laparoscopic skills acquisition. Surg Endosc 21, 209–213 (2007). https://doi.org/10.1007/s00464-006-0149-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-006-0149-6