Laparoscopic skills training using a webcam trainer.

PURPOSE Many sophisticated and expensive trainers have been developed to assist surgeons in learning basic laparoscopic skills. We developed an inexpensive trainer and evaluated its effectiveness. MATERIALS AND METHODS The webcam laparoscopic training device is composed of a webcam, cardboard box, desk lamp and home computer. This homemade trainer was evaluated against 2 commercially available systems, namely the video Pelvitrainer (Karl Storz Endoscopy, Culver City, California) and the dual mirror Simuview (Simulab Corp., Seattle, Washington). The Pelvitrainer consists of a fiberglass box, single lens optic laparoscope, fiberoptic light source, endoscopic camera and video monitor, while the Simuview trainer uses 2 offset, facing mirrors and an uncovered plastic box. A total of 42 participants without prior laparoscopic training were enrolled in the study and asked to execute 2 tasks, that is peg transfer and pattern cutting. Participants were randomly assigned to 6 groups with each group representing a different permutation of trainers to be used. The time required for participants to complete each task was recorded and differences in performance were calculated. Paired t tests, the Wilcoxon signed rank test and ANOVA were performed to analyze the statistical difference in performance times for all conditions. RESULTS Statistical analyses of the 2 tasks showed no significant difference for the video and webcam trainers. However, the mirror trainer gave significantly higher outcome values for tasks 1 and 2 compared to the video (p = 0.01 and <0.01) and webcam (p = 0.04 and <0.01, respectively) methods. ANOVA indicated no overall difference for tasks 1 and 2 across the orderings (p = 0.36 and 0.99, respectively). However, by attempt 3 the time required to complete the skill tests decreased significantly for all 3 trainers (each p <0.01). CONCLUSIONS Our homemade webcam system is comparable in function to the more elaborate video trainer but superior to the dual mirror trainer. For novice laparoscopists we believe that the webcam system is an inexpensive and effective laparoscopic training device. Furthermore, the webcam system also allows instant recording and review of techniques.

[1]  J. Lingeman,et al.  Training postgraduate urologists in laparoscopic surgery: the current challenge. , 2002, The Journal of urology.

[2]  M. Mughal,et al.  A cheap laparoscopic surgery trainer. , 1992, Annals of the Royal College of Surgeons of England.

[3]  A. E. Park,et al.  Evaluating minimally invasive surgery training using low-cost mechanical simulations , 2003, Surgical Endoscopy And Other Interventional Techniques.

[4]  J. Hamdorf,et al.  Acquiring surgical skills , 2000, The British journal of surgery.

[5]  C. D. Smith,et al.  A computer-based laparoscopic skills assessment device differentiates experienced from novice laparoscopic surgeons , 2001, Surgical Endoscopy.

[6]  R. Reznick,et al.  Objective structured assessment of technical skill (OSATS) for surgical residents , 1997, The British journal of surgery.

[7]  A. Derossis,et al.  Housestaff performance is improved by participation in a laparoscopic skills curriculum. , 2002, American journal of surgery.

[8]  S Gue.  Home-made videoscopic trainer for operative laparoscopic surgery. , 1995, The Australian and New Zealand journal of surgery.

[9]  H. Lönroth,et al.  The transfer of basic skills learned in a laparoscopic simulator to the operating room , 2002, Surgical Endoscopy And Other Interventional Techniques.

[10]  Vadim Sherman,et al.  Using simulators to assess laparoscopic competence: ready for widespread use? , 2004, Surgery.

[11]  C. Frantzides,et al.  Assessment of Individual Hand Performance in Box Trainers Compared to Virtual Reality Trainers , 2003, The American surgeon.

[12]  Daniel B. Jones,et al.  Improving operative performance using a laparoscopic hernia simulator. , 2001, American journal of surgery.

[13]  Ronald C Merrell,et al.  Training in laparoscopic suturing skills using a new computer-based virtual reality simulator (MIST-VR) provides results comparable to those with an established pelvic trainer system. , 2002, Journal of laparoendoscopic & advanced surgical techniques. Part A.