Abstract
Introduction: Nowadays, laparoscopic operations are a common part of surgical practice. However, they have their own characteristics and require a specific method of preparation.
Recently, simulation techniques have been increasingly used for the training of skills. The aim of this review is to provide a summary of available literature on the topic of laparoscopic simulators, to assess their contribution to the training of surgeons, and to identify the most effective type of simulation.
Methods: PubMed database, Web of Science and Cochrane Library were used to search for relevant publications. The keywords "laparoscopy, simulator, surgery, assessment" were used in the search.
The search was limited to prospective studies published in the last 5 years in the English language. Results: From a total of 354 studies found, we included in the survey 26 that matched our criteria.
Nine studies compared individual simulators to one another. Five studies evaluated "high and low fidelity" (a virtual box simulator) as equally effective (EBM 2a).
In three cases the "low fidelity" box simulator was found to be more efficient (EBM 2aMINUS SIGN 3b). Only one study preferred the virtual simulator (VR) (EBM2b).
Thirteen studies evaluated the benefits of simulators for practice. Twelve found training on a simulator to be an effective method of preparation (EBM 1bMINUS SIGN 3b).
In contrast, one study did not find any difference between the training simulator and traditional preparation (EBM 3b). Nine studies evaluated directly one of the methods of evaluating laparoscopic skills.
Three studies evaluated VR simulator as a useful assessment tool. Other studies evaluated as successful the scoring system GOALS-GH.
The hand motion analysis model was successful in one case. Most studies were observational (EBM 3b) and only 2 studies were of higher quality (EBM 2b).
Conclusion: Simulators are an effective tool for practicing laparoscopic techniques (EBM: 1b).