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The participant is positioned and provided laparoscopic scissors and the same choices of needle drivers or grasper offered in Exercise L-3 (see Video 4, http://links.lww.com/xxx). The exercise goal was to pass a 15-cm 2-0 polygalactin 910 suture (Vicryl), swedged on to a 26-mm ½ curved tapered needle through the marks on the Penrose and approximate the defect with a knot comprising three intracorporeally formed throws, the first of which was a double throw —a surgeon’s knot. The maximal allowed time and errors recorded were identical to those for Exercise L-3. Video created by AAGL. Used with permission.