A simplified simulator for the training and evaluation of laparoscopic skills

Background: Laparoscopic skills can be measured objectively in a video-laparoscopic cart simulator system. These scores have been shown to be sufficiently sensitive to distinguish differences in performance between residents at different levels of training. The purpose of this study was to compare a simplified mirrored-box simulator to the videolaparoscopic cart system. Methods: A total of 22 surgical residents performed seven structured tasks in both simulators in random order. Scores reflected precision and speed. The tasks were transferring, cutting, clip + divide, looping, mesh placement + fixation, and suturing with intracorporeal and extracorporeal knots. Results: There were no significant differences in mean raw scores between the simulators for six of the seven tasks. Resident total scores correlated well between simulators (r = 0.68, p = 0.001), Resident ranking also correlated well (r = 0.69, p < 0.001), Conclusions: A mirrored-box simulator was shown to provide a reasonable reflection of relative performance of laparoscopic skills. Practical, effective laparoscopic skills training and evaluation can be accomplished without the need for cumbersome equipment.