Virtual reality computer simulation - An objective method for the evaluation of laparoscopic surgical skills

Background: Objective assessment of psychomotor skills should be an essential component of a modern surgical training program. There are computer systems that can be used for this purpose, but their wide application is not yet generally accepted. The aim of this study was to validate the role of virtual reality computer simulation as a method for evaluating: surgical laparoscopic skills. Methods: The study included 14 surgical residents. On day 1, they performed two runs of all six tasks on the Minimally Invasive Surgical Trainer, Virtual Reality (MIST-VR), On day 2, they performed a laparoscopic cholecystectomy on living pigs; afterward, they were tested again on the MIST-VR. A group of experienced surgeons evaluated the trainees' performance on the animal operation, giving scores for total performance error and economy of motion. During the tasks on the MIST-VR, errors and noneconomy of movements for the left and right hand were also recorded. Results: There were significant correlations between error scores in vivo and three of the six in vitro tasks (p < 0.05). In vivo economy scores correlated significantly with noneconomy right-hand scores for five of the six tasks and with non-economy left-hand scores for one of the six tasks (p < 0.05). Conclusion: In this study, laparoscopic performance in the animal model correlated significantly with performance on the computer simulator. Thus, the computer model seems to be a promising objective method for the assessment of laparoscopic psychomotor skills.