LapSim virtual reality laparoscopic simulator reflects clinical experience in German surgeons

The aim of this study was to analyze the ability of a training module on a virtual laparoscopic simulator to assess surgical experience in laparoscopy.

One hundred and fifteen participants at the 120th annual convent of the German surgical society took part in this study. All participants were stratified into two groups, one with laparoscopic experience of less than 50 operations (group 1, n=61) and one with laparoscopic experience of more than 50 laparoscopic operations (group 2, n=54). All subjects completed a laparoscopic training module consisting of five different exercises for navigation, coordination, grasping, cutting and clipping. The time to perform each task was measured, as were the path lengths of the instruments and their respective angles representing the economy of the movements. Results between groups were compared using χ² or Mann–Whitney U-test.

Group 1 needed more time for completion of the exercises (median 424 s, range 99–1,376 s) than group 2 (median 315 s, range 168–625 s) (P<0.01). Instrument movements were less economic in group 1 with larger angular pathways, e.g. in the cutting exercise (median 352°, range 104–1,628° vs median 204°, range 107–444°, P<0.01), and longer path lengths (each instrument P<0.05).

As time for completion of exercises, instrument path lengths and angular paths are indicators of clinical experience, it can be concluded that laparoscopic skills acquired in the operating room transfer into virtual reality. A laparoscopic simulator can serve as an instrument for the assessment of experience in laparoscopic surgery.