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Impact of Super Monkey Ball and Underground video games on basic and advanced laparoscopic skill training



This abstract profiles the comparison of correlations between previously validated Super Monkey Ball (SMB) and recently introduced Underground (U) video game on the Nintendo Wii U to multiple validated tasks used for developing basic and advanced laparoscopic skills.


Sixty-eight participants, 53 residents and 15 attending surgeons, performed the Top Gun Pea Drop, FLS Peg Pass, intracorporeal suturing, and two video games (SMB and U). SMB is an over-the-counter game, and U was formulated for laparoscopic skill training.


Spearman’s rank correlations were performed looking at performance comparing the three validated laparoscopic training tasks, and SMB/U. The SMB score had a moderate correlation with intracorporeal suturing (ρ = 0.39, p < 0.01), and the final score involving all three tasks (ρ = 0.39, p < 0.01), but low correlations with Pea Drop Drill and FLS Peg Transfer (ρ = 0.11, 0.18, p < 0.01). The U score had a small correlation with intracorporeal suturing and final score (ρ = 0.09, 0.13, p < 0.01). However, there were correlations between U score and Pea Drop Drill, and FLS Peg Transfer (ρ = 0.24, 0.27, p < 0.01, respectively).


In this study, SMB had a very significant correlation with intracorporeal suturing. U demonstrated more of a correlation with basic skills. At this point, our conclusion would be that both are effective for laparoscopic skill training, and they should be used in tandem rather than alone.

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Correspondence to James C. Rosser Jr..

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James C. Rosser Jr., Xinwei Liu, Charles Jacobs, Katherine Mia Choi, Maarten B. Jalink, and Henk O. ten Cate Hoedemaker have no conflicts of interest or financial ties to disclose.

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Rosser, J.C., Liu, X., Jacobs, C. et al. Impact of Super Monkey Ball and Underground video games on basic and advanced laparoscopic skill training. Surg Endosc 31, 1544–1549 (2017).

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