An integrated laparoscopic simulator (i-Sim) to develop surgical skills outside the operating theatre: a novel means to improve training facilities in the UK.

ABSTRACT

BACKGROUND: Minimal access surgery (MAS) is increasingly replacing open surgery. However, access to training in laparoscopy remains lacking. We propose the use of a novel and integrated laparoscopic simulator (i-Sim) to develop surgical skills. OBJECTIVES: This pilot study set out to evaluate access to laparoscopic training facilities in the UK. It was then examined whether i-Sim might be a better alternative to the mannequin/box trainer with stack system. METHODS: Questionnaires were sent to consultants and trainees in urology, general surgery and gynaecology to survey current access to laparoscopic training in the UK. A further group was requested to give feature scores for i-Sim compared to a conventional mannequin/box trainer with stack system. RESULTS: Of those with laparoscopic experience, 36% believed they had opportunities in laparoscopic training only during operations while 17% felt they had no access to training facilities for laparoscopy. Overall, 93% thought a laparoscopic simulator would be useful for training. In the second survey, feature (set-up, image quality, user-friendliness, ease to change tasks, portability, different locations, storage) scores were given; i-Sim scored a significantly higher (p<0.0001) satisfaction rating than the mannequin/box trainer with stack system. CONCLUSIONS: There is a paucity of regular training facilities for MAS in the UK and there was an exceptionally strong agreement among our participants that regular training on laparoscopic simulators would be useful. Additionally, i-Sim offers the possibility of a readily accessible alternative to current training approaches to laparoscopy.