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.

Patient(s): Twenty-five in-training gynecological endoscopists and 15 medical students.

Intervention(s): A demonstration of 10 laparoscopic skill tasks was shown to participants before administration of a pretest. Voluntary rounds of further trials were encouraged thereafter. The post-tests were administered 5 days later. Assessments were conducted by the same independent supervisor.

Main Outcome Measure(s): Improvements in overall scores and relative performance mean scores were compared using the independent t test. The comparison of various trial groups' mean was evaluated by one-way analysis of variance (ANOVA).

Result(s): There were significantly better post-test scores in all tasks for both groups compared to the pretest scores. There was no statistical difference between the overall relative training outcomes of both groups. There was a significant difference in group mean scores between the group of trainees who performed five or more rounds of trials and those who performed two to three trials.

Conclusion(s): The LTS3e simulator contributes to the acquisition of laparoscopic skills in less experienced surgeons. Performance improves progressively with practice.