Surgical Endoscopy

, Volume 26, Issue 9, pp 2550–2558 | Cite as

A head-to-head comparison between virtual reality and physical reality simulation training for basic skills acquisition

  • Constantinos Loukas
  • Nikolaos Nikiteas
  • Dimitrios Schizas
  • Vasileios Lahanas
  • Evangelos Georgiou



This study aimed to investigate whether basic laparoscopic skills acquired with a virtual reality simulator (LapVR™) are transferable to a standard video trainer (VT) and vice versa.


Three basic tasks were considered: peg transfer, cutting, and knot-tying. The physical models were custom-built as identical copies of the virtual models. Forty-four novices were randomized into two equal groups to be trained on the LapVR™ or the VT. Each task was practiced separately 12 times. Transferability of skills from one modality to the other was assessed by performing the same task on the alternative modality before and after training (crossover assessment). Performance metrics included path length, time, and penalty score.


Both groups demonstrated significant performance curves for all tasks and metrics (p < 0.05). Plateaus were statistically equivalent between the groups for each task in terms of path length and time, and across all tasks in terms of the penalty score (p < 0.05). When each group was tested on the alternative modality there was a significant improvement for all tasks and metrics (p < 0.05). Comparing the plateau performance of one group with the performance achieved on the same simulator by the other group we found (a) no statistical deference in the penalty score (p < 0.05), (b) a statistical difference in time and path length for cutting and knot-tying (p < 0.05), and (c) an equal time performance for peg transfer (p < 0.05) but not for path length (p < 0.05).


Both modalities provided significant enhancement of the novices’ performance. The skills learned on the LapVR™ are transferable to the VT and vice versa. However, training with one modality does not necessarily mean a performance equivalent to that achieved with the other modality.


Surgical training Virtual reality Simulation Laparoscopic surgery Video trainer Education 


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Constantinos Loukas
    • 1
  • Nikolaos Nikiteas
    • 1
  • Dimitrios Schizas
    • 1
  • Vasileios Lahanas
    • 1
  • Evangelos Georgiou
    • 1
  1. 1.Medical Physics Lab-Simulation Center, Medical SchoolUniversity of AthensAthensGreece

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