Virtual reality training in laparoscopic surgery: A preliminary assessmentof minimally invasive surgical trainer virtual reality (MIST VR)

Background: The "fulcrum effect" of the body wall on surgical instrument ma nipulation is a major hurdle for no tice endoscopic surgeons. Virtual reali ty training has not previously been evaluated as a means to overcome this p roblem. Materials and Methods: 16 participants with no experience of endoscopy were required to make multiple defined incisions under laparoscopic laboratory conditions within 2-minute periods. Half of the subjects were randomized to receive initial training on the Minimally Invasive Surgical Trainer, Virtu al Reality (MIST VR) computer programme. Results: Participants with MIST VR training made significantly more correct incisions (P = 0.0001) than the control group on test trial 1, and even af ter extended practice by both groups (P = 0.0001). They were also significa ntly more likely to actively use both hands to perform the endoscopic evalu ation task (P = 0.01). Conclusions: Virtual reality training represents a potential, viable soluti on for junior endoscopists, for overcoming the "fulcrum effect", in a repli cable, safe learning environment which allows objective and reliable quanti fication of skill levels by trainers.