title: Virtual reality training in laparoscopic surgery: a preliminary assessment of minimally invasive surgical trainer virtual reality (MIST VR).
abstract: BACKGROUND
  The "fulcrum effect" of the body wall on surgical instrument manipulation is a major hurdle for novice endoscopic surgeons. Virtual reality training has not previously been evaluated as a means to overcome this problem.
  
  
  METHODS
  16 participants with no experience of endoscopy were required to make multiple defined incisions under laparoscopic laboratory conditions within 2-minute periods. Half of the subjects were randomized to receive initial training on the Minimally Invasive Surgical Trainer, Virtual Reality (MIST VR) computer programme.
  
  
  RESULTS
  Participants with MIST VR training made significantly more correct incisions (P = 0.0001) than the control group on test trial 1, and even after extended practice by both groups (P = 0.0001). They were also significantly more likely to actively use both hands to perform the endoscopic evaluation task (P = 0.01).
  
  
  CONCLUSIONS
  Virtual reality training represents a potential, viable solution for junior endoscopists, for overcoming the "fulcrum effect", in a replicable, safe learning environment which allows objective and reliable quantification of skill levels by trainers.
authors.affiliation: Queen's University Centre for Endoscopic Training and Research, Queen's University, Belfast, Northern Ireland. ag.gallagher@qub.ac.uk
authors.forename: A G
authors.initials: AG
authors.lastname: Gallagher
authors.forename: N
authors.initials: N
authors.lastname: McClure
authors.forename: J
authors.initials: J
authors.lastname: McGuigan
authors.forename: I
authors.initials: I
authors.lastname: Crothers
authors.forename: J
authors.initials: J
authors.lastname: Browning
mesh_terms: D000328:Adult; D004501:Education, Medical; D013502:General Surgery / Q000193:education*; D006801:Humans; D010535:Laparoscopy; D011597:Psychomotor Performance; D014584:User-Computer Interface