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Validation of a virtual intracorporeal suturing simulator

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A Correction to this article was published on 05 December 2018

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Intracorporeal suturing is one of the most important and difficult procedures in laparoscopic surgery. Practicing on a FLS trainer box is effective but requires large number of consumables, and the scoring is somewhat subjective and not immediate. A virtualbasic laparoscopic skill trainer (VBLaST©) was developed to simulate the five tasks of the FLS Trainer Box. The purpose of this study is to evaluate the face and content validity of the VBLaST suturing simulator (VBLaST-SS©).


Twenty-five medical students and residents completed an evaluation of the simulator. The participants were asked to perform the standard intracorporeal suturing task on both VBLaST-SS© and the traditional FLS box trainer. The performance scores on each system were calculated based on time (s), deviations to the black dots (mm), and incision gap (mm). The participants were then asked to finish a 13-item questionnaire with ratings from 1 (not realistic/useful) to 5 (very realistic/useful) regarding the face validity of the simulator. A Wilcoxon signed rank test was performed to identify differences in performance on the VBLaST-SS© compared to that of the traditional FLS box trainer.


Three questions from the face validity questionnaire were excluded due to lack of response. Ratings to 8 of the remaining 10 questions (80%) averaged above 3.0 out of 5. Average intracorporeal suturing completion time on the VBLaST-SS© was 421 (SD = 168 s) seconds compared to 406 (175 s) seconds on the box trainer (p = 0.620). There was a significant difference between systems for the incision gap (p = 0.048). Deviation in needle insertion from the black dot was smaller for the box trainer than the virtual simulator (1.68 vs. 7.12, p < 0.001).


Participants showed comparable performance on the VBLaST-SS© and traditional box trainer. Overall, the VBLaST-SS© system showed face validity and has the potential to support training for the suturing skills.

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Change history

  • 05 December 2018

    The surname of Sreekanth Arikatla incorrectly appeared as Sreekanth Artikala.


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This work was supported by the NIBIB/NIH Grant #5R44EB019802.

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Correspondence to Lora Cavuoto.

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Yaoyu Fu and Drs. Lora Cavuoto, Di Qi, Karthikeyan Panneerselvam, Gene Yang, Venkata Sreekanth Artikala, Andinet Enquobahrie, Suvranu De have no conflicts of interest or financial ties to disclose. Dr Schwaitzberg has no relevant conflicts related to this manuscript and is a consultant for Activ Surgical, Human Extensions, Arch Therapeutics, Acuitiy Bio, and Nu View Surgical.

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Fu, Y., Cavuoto, L., Qi, D. et al. Validation of a virtual intracorporeal suturing simulator. Surg Endosc 33, 2468–2472 (2019).

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