Development of a Low-Cost System for Laparoscopic Skills Training.

Technological advancements in video equipment and biocompatible materials have enabled improvements in complex surgery through small incisions. The mastery of these laparoscopic surgical techniques is now a requirement for surgeons, however, the necessary skills are not intuitive and require hundreds of practice hours. The current state of surgical education includes animate models, inanimate physical models, and computer-based simulations, the latter of which are limited by cost, accessibility, and a lack of engagement. We propose a novel low-cost training interface that mimics the laparoscopic surgical environment using customized instruments whose movement and control are used as inputs for video games. The system is significantly less expensive than commercial systems and allows users freedom to select and play any game, enabling a take-home system with potential for higher levels of engagement, as well as familiarity and expertise with ambidextrous laparoscopic hand motion. A preliminary study compared performance on FLS (Fundamentals of Laparoscopic Surgery) testing before and after training. For a precision cutting task, groups that trained on a standard simulator or on the new system with either a noninverted or inverted hand-instrument mapping showed statistically significant improvements, warranting further investigation of training with this new system.