Virtual reality training leads to faster adaptation to the novel psychomotor restrictions encountered by laparoscopic surgeons

Background: The fulcrum effect of the body wall on instrument handling pose s a major obstacle to the mastery of instrument coordination for junior lap aroscopic surgeons. This study evaluated three types of laparoscopic simula tor training to assess their ability to promote the user's adaptation to th e fulcrum effect. Methods: Thirty-two participants with no previous experience in laparoscopi c surgery were randomly assigned to one of four groups representing differe nt training conditions. One group was assigned to use a virtual reality sim ulator (MIST VR); two others were given a laparoscopic Z or U maze-tracking task. The control group received no training. Subjects were asked to perfo rm a 2-min laparoscopic cutting task under normal laparoscopic imaging cond itions first Z before and then after training. Results: In the test trial, subjects who trained on MIST VR made significan tly more correct incisions (p < 0.0001) and fewer incorrect incisions (p < 0.0001). Conclusion: Training on a virtual reality simulator such as MIST VR helps l aparoscopic novices adapt to the fulcrum effect faster.