Lucas SM et al. (2008) Training on a virtual reality laparoscopic simulator improves performance of an unfamiliar live laparoscopic procedure. J Urol 180: 2588–2591

A study from the University of Texas has found that laparoscopic simulator training can improve the ability of students to perform urological procedures, even when the training simulation is for a completely unrelated procedure. The results of the study indicate that the skills learned on laparoscopic simulators are transferable between procedures.

Lucas et al. enrolled 32 first-year and second-year medical students, none of whom had previous laparoscopic experience. All 32 students performed a laparoscopic cholecystectomy on a LAP Mentor™ simulator (Simbionix USA Corp., Cleveland, OH). Performance was assessed using the Objective Structural Assessment of Technical Skills (OSATS). The students were then randomly assigned to a program of six unsupervised 30 min training sessions, or no training. The students who underwent training were encouraged to practice lens manipulation, hand–eye coordination exercises, grasping, clipping, two-handed maneuvers, cutting, fulguration, and object translocation. At the end of the training period, all 32 students, after watching a demonstration of the procedure, performed a porcine laparoscopic nephrectomy. The OSATS scores for the initial cholecystectomy simulation were similar in both groups; however, for the nephrectomy, the students who received simulator training significantly outperformed those who did not (mean OSATS score 21.0 ± 6.8 vs 15.7 ± 6.6).

The authors conclude that general laparoscopy skills developed on a simulator might be applicable to unrelated procedures. As the present study involved novices, the potential value of such training in more-experienced operators should be investigated.