A systematic review of low-cost laparoscopic simulators

Area of Science:

• Surgical Education
• Medical Simulation
• Laparoscopic Surgery Training

Background:

• Workplace surgical skills practice is limited by cost, time, and accessibility for junior trainees.
• A need exists for accessible, at-home alternatives to practice laparoscopic skills.
• High-fidelity simulation in the workplace presents significant constraints.

Purpose of the Study:

• To systematically review low-cost laparoscopic simulators suitable for home practice.
• To identify key components, costs, and validation status of available simulators.

Main Methods:

• Systematic review following PRISMA guidelines.
• Searched MEDLINE/EMBASE (1990-2014) for portable, low-cost laparoscopic simulators.
• Excluded non-English articles, inadequately described simulators, and those costing over £1500.

Main Results:

• Identified 73 unique simulators (60 non-commercial, 13 commercial).
• Non-commercial simulators were cheaper (£3-£216) and easier to assemble using off-the-shelf parts.
• Commercial simulators showed higher validation rates (92% vs 55%) and better face validation.

Conclusions:

• Simple, affordable self-assembly options exist, but validation is inconsistent for non-commercial models.
• Portable simulators offer an equitable solution for regular basic laparoscopic skills practice.
• Further validation is needed for many low-cost, non-commercial laparoscopic simulators.