Simulation training in laparoscopy using a computerized physical reality simulator.

Objective: To describe a new simulator, SurgicalSIM LTS, and summarize our preliminary experience with system.

Methods: LTS was evaluated in 3 studies: (1) 124 participants from 3 Canadian universities: 13 students; 30 residents, fellows, attendings from surgery; 59 gynecologists; 22 urologists were classified based on laparoscopic experience as novice, intermediate, competent, or expert. All were tested on the LTS.

Choosing the right physical laparoscopic simulator? Comparison of LTS2000-ISM60 with MISTELS: validation, correlation, and user satisfaction.

Background: The LTS 2000-ISM60 (LTS; Realsim Systems, Alburquerque, NM, USA) is a computer enhanced video-laparoscopic training system. Our purpose was to validate the LTS and to correlate its scoring performance with that of the McGill Inanimate System for Training and Evaluation of Laparoscopic Skills (MISTELS), a widely used and well-validated physical simulator.

Methods: Participants (n = 124) included medical students, residents, fellows, and attending surgeons from general surgery, gynecology, and urology in 3 Canadian universities.

Enhancing laparoscopic performance with the LTS3E: a computerized hybrid physical reality simulator.

Objective: To determine the value of this simulator in acquiring basic laparoscopic skills and to evaluate the correlation between the frequency of trials and performance.

Design: Cross-sectional study.

Setting: Department of Obstetrics and Gynecology, University Hospital Schleswig-Holstein, Kiel, Germany.

Criterion-based training with surgical simulators: proficiency of experienced surgeons.

Objective: In our effort to establish criterion-based skills training for surgeons, we assessed the performance of 17 experienced laparoscopic surgeons on basic technical surgical skills recorded electronically in 26 modules selected in 5 commercially available, computer-based simulators.

Methods: Performance data were derived from selected surgeons randomly assigned to simulator stations, and practicing repetitively during one and one-half day sessions on 5 different simulators. We measured surgeon proficiency defined as efficient, error-free performance and developed proficiency score formulas for each module.

Core competency in laparoendoscopic surgery.

Background: Concern about patient safety and physician competence was highlighted by the Institute of Medicine report, revealing the prevalence of fatal medical errors. There is also awareness that technical difficulties specific to laparoendoscopic surgery can cause medical errors. Reported herein is a review of the evidence pertaining to objective assessment of core competency components in laparoendoscopic surgery: cognitive skills, technical skills, surgical performance, and judgment.

Physical reality simulation for training of laparoscopists in the 21st century. A multispecialty, multi-institutional study.

Background: Simulation is the most effective and safe way to train laparoscopic surgeons in an era of limited work hours, lack of funding, and increasing malpractice costs. However, the costs associated with the use of virtual reality simulators are significant, and although very technically sophisticated they still lack tactile feedback. We are proposing a physical reality simulator, the LTS 2000, as a reliable and effective alternative to virtual reality.

Ischemic necrosis of small bowel following laparoscopic surgery.

Background And Objective: Small bowel ischemia following laparoscopy was described recently as a rare fatal complication of the CO2 pneumoperitoneum. Of the 8 cases reported in the surgical literature, 7 were fatal, 1 was not. In this report, we describe the first gynecological case.