Enhancing laparoscopic performance with the LTS3E: a computerized hybrid physical reality simulator

Objective To determine the value of this simulator in acquiring basic laparoscopic skills and to evaluate the correlation between the frequency of trials and performance. Design Cross-sectional study. Setting Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Kiel, Germany. Patient(s) Twenty-five in-training gynecological endoscopists and 15 medical students. Intervention(s) A demonstration of 10 laparoscopic skill tasks was shown to participants before administration of a pretest. Voluntary rounds of further trials were encouraged thereafter. The post-tests were administered 5 days later. Assessments were conducted by the same independent supervisor. Main Outcome Measure(s) Improvements in overall scores and relative performance mean scores were compared using the independent t test. The comparison of various trial groups' mean was evaluated by one-way analysis of variance (ANOVA). Result(s) There were significantly better post-test scores in all tasks for both groups compared to the pretest scores. There was no statistical difference between the overall relative training outcomes of both groups. There was a significant difference in group mean scores between the group of trainees who performed five or more rounds of trials and those who performed two to three trials. Conclusion(s) The LTS3e simulator contributes to the acquisition of laparoscopic skills in less experienced surgeons. Performance improves progressively with practice.