[Simulation of endoscopic procedures--an innovation to improve laparoscopic technical skills]

Laparoscopic surgery is a technically more demanding procedure compared to open surgery. Safe realistic training and unbiased quantitative assessment of technical skills are required for laparoscopic surgery. Virtual reality (VR) simulators may be useful tools for training and assessing basic and advanced surgical skills and procedures.

to assess the acquisition of laparoscopic skills using virtual reality simulators.

systematic review of the literature.

(1) The simulator can be used to objectively assess the laparoscopic skills of surgeons and distinguish between novices and experienced laparoscopic surgeons. (Evidence level III-B) (2) The target group as well as the benefit of a three-day practical course for laparoscopic surgery can be determined by the simulator. (Evidence level III-C) (3) Novices in laparoscopic surgery seem to benefit mostly from simulation training. (Evidence level III-B) (4) Steepness and plateau of a learning curve may be more dependent on the level of performance required by the particular training session rather than the number of repetitions during a training session. (Evidence level III-B) (5) Clinical background and understanding of the clinical value of a training program lead to faster acquisition and improvement of laparoscopic skills as performed on the laparoscopy simulator. (Evidence level III-B) (6) Non technical skills such as visual-spatial perception and stress coping positively correlates with virtual laparoscopic skills. (Evidence level III-B).

To date, the best method for teaching laparoscopic surgery has not been defined. However, the use of virtual simulators for laparoscopy training is useful when learning basic techniques allow the surgeon to improve hand dexterity and coordination in laparoscopic surgery.