Virtual laparoscopic surgical skills practice using a multi-degree of freedom joystick

The objective of this study was to compare three different surgical skills practice environments while performing a virtual laparoscopic surgical training task using a multi-degree of freedom joystick, a commercial manipulator or a training box. Nine subjects performed a virtual peg transfer task and their upper extremity muscle effort and fatigue were measured. The results demonstrated a similar muscle effort and fatigue of the upper extremity among the three training environments. Subjects with medical backgrounds used significantly higher muscle effort when they performed the training task using the joystick than the manipulator, but used similar muscle effort between the joystick and the training box. This study suggests that the multi-degree of freedom joystick could provide more options to practice virtual laparoscopic surgical training tasks with muscle effort and fatigue similar to other traditional training boxes.