State of the Evidence on Simulation-Based Training for Laparoscopic Surgery: A Systematic Review

  title={State of the Evidence on Simulation-Based Training for Laparoscopic Surgery: A Systematic Review},
  author={Benjamin Zendejas and Ryan Brydges and Stanley J. Hamstra and David A. Cook},
  journal={Annals of Surgery},
OBJECTIVE Summarize the outcomes and best practices of simulation training for laparoscopic surgery. [] Key Method We used random effects to pool effect sizes. RESULTS From 10,903 articles screened, we identified 219 eligible studies enrolling 7138 trainees, including 91 (42%) randomized trials.

Transferability of Simulation-Based Training in Laparoscopic Surgeries: A Systematic Review

Simulation provides a safe, effective, and ethical way for residents to acquire surgical skills before entering the operating room, and simulation-trained participants showed superiority in surgical performance in comparison with untrained surgeons.

Development of an evidence-based training program for laparoscopic hysterectomy on a virtual reality simulator

The VR program for LH accrued validity evidence and allowed the development of an evidence-based and stepwise training curriculum using a structured scientific methodology.

Off-site training of laparoscopic skills, a scoping review using a thematic analysis

Directed self-regulated learning has the potential to improve off-site laparoscopic skills training; however, further studies are needed to demonstrate the effect of this type of instructional design.

Virtual reality simulation training in endoscopy: a Cochrane review and meta-analysis.

Virtual reality simulation training is advantageous over no training and can supplement conventional endoscopy training and there is insufficient evidence that simulation training provides benefit over conventional training.

A Systematic Review of the Educational Effectiveness of Simulation Used in Open Surgery

Overall, the use of the simulators was more educationally effective compared with standard teaching of the skill without a simulator (P < 0.05).


This study demonstrated significantly improved levels of performance for all skill sets for novicesurgical residents trained on LAP Sim for minimally invasive surgical procedures.

The Implementation Gap in Laparoscopic Simulation Training

An implementation gap in laparoscopic simulation-based training still exists in Scandinavia, and research in medical education has moved from demonstrating transferability of simulation training to the operating room to how to best implement it.

Surgical skills simulation: a shift in the conversation.

The skills laboratory is identified as the appropriate environment for laparoscopic skills acquisition and those who doubt the benefit of simulation-based laparoscope training are silenced.



A Systematic Review of Skills Transfer After Surgical Simulation Training

Skills acquired by simulation-based training seem to be transferable to the operative setting and more studies are required to strengthen the evidence base and to provide the evidence needed to determine the extent to which simulation should become a part of surgical training programs.

Surgical Simulation: A Systematic Review

While there may be compelling reasons to reduce reliance on patients, cadavers, and animals for surgical training, none of the methods of simulated training has yet been shown to be better than other forms of surgical training.

Mental Training in Surgical Education: A Randomized Controlled Trial

Additional mental training is an effective way of optimizing the outcomes of further training for laparoscopic cholecystectomy and is associated with fewer costs and with better outcomes in some crucial assessment scales than additional practical training.

Mental Practice Enhances Surgical Technical Skills: A Randomized Controlled Study

This is the first randomized controlled study to show that MP enhances the quality of performance based on VR laparoscopic cholecystectomy, and may be a time- and cost-effective strategy to augment traditional training in the OR thus potentially improving patient care.

A simplified simulator for the training and evaluation of laparoscopic skills

A mirrored-box simulator was shown to provide a reasonable reflection of relative performance of laparoscopic skills and can be accomplished without the need for cumbersome equipment.

Usefulness of a virtual reality simulator or training box for endoscopic surgery training

It is demonstrated that a simulator is useful for acquiring psychomotor skills, but does not immediately enable clinical performance of an operation.