After selecting a side of the trainer box, each participant was provided laparoscopic scissors and then chose a standardized, non–self-righting Fundamentals in Laparoscopic Surgery laparoscopic needle driver, and another grasping instrument—either another identical needle driver or one of the Maryland forceps. The exercise goal was to pass a 90-cm 2-0 silk suture with a swedged-on 26mm, ½ curved, and tapered needle through the paired target marks on the Penrose. Then, participants approximated the linear defect with a knot comprising three, single, extracorporeally formed throws, each sequentially transferred into the trainer and tightened with a choice of two knot manipulators. To end the exercise, the participant was required to cut both ends of the suture with the laparoscopic scissors. Video created by AAGL. Used with permission.