For more than a decade box trainers are regarded as the basic tool for laparoscopic skills training; however, based on real operating room systems, these are very expensive and require dedicated centers and expertise to utilize. The aim of this study is to evaluate a new and relatively cheep box trainer relying on contemporary visualization and computer connectivity technologies.
32 participants with varying levels of skill in minimally invasive surgery (MIS) took part in this study. The box trainer used was the LapTrainer with Simu Vision TM (Simulab, USA), utilizing a simple plastic box, a web cam and a USB 2.0 card. Laparoscopic instruments comprised of standard OR tools. Following a short warm up session, participants were required to perform three tasks of increasing level of complexity (rope passing, peg transfer and intracorporeal knot tying). All tasks were video recorded and blindly assessed by two experts using error scores, performance checklists and time to completion. Statistical analysis included non parametric tests and Cronbach’s alpha for inter rater reliability. A p<0.05 was considered significant.
Highly significant differences were noted between the four study groups (novices, junior trainees, senior trainees and experts) in all tasks and for all parameters (Kruskal Walis, p=0.001). Inter rater reliability (IRR) was as high as 0.88 (range 0.83–0.98) for all tasks assessed. 90% of the participants have rated the simulator as good or very good (80–100%) by means of a five point Lickert scale questionnaire.
The Simulab LapTrainer provides a valid alternative for skills training. Furthermore, its simplicity and relatively low price (5% of conventional video trainers) makes it a worthy and yet an inexpensive training system for most surgical departments thus, allowing in-house on going skills training.
Conflict of Interest:
Authors indicated they have nothing to disclose.