Mechanical simulators for training for laparoscopic surgery in urology.
OBJECTIVE
The introduction of laparoscopic surgery into urology has led to new training concepts differing significantly from previous concepts of training for open surgery. This paper focuses on the type and importance of mechanical simulators in laparoscopic training.


METHODS
On the basis of our own studies and experience with the development of various concepts of laparoscopic training, including different modules (i.e., Pelvi-trainer, animal models, clinical mentoring) since 1991, we reviewed the current literature concerning all types of simulators. We focused on training for laparoscopic ablative and reconstructive surgery using mechanical simulators.


RESULTS
The principle of a mechanical simulator (i.e., a box with the possibility of trocar insertion) has not changed during the last decade. However, the types of Pelvi-trainers and the models used inside have been improved significantly. According to the task of the simulator, various sophisticated models have been developed, including standardized phantoms, animal organs, and even perfused segments of porcine organs. For laparoscopic suturing, various step-by-step training concepts have been presented. These can be used for determination of the ability of a physician with an interest in laparoscopic surgery, but also to classify the training status of a laparosopic surgeon.


CONCLUSIONS
Training in laparoscopic surgery has become an important topic, not only in learning a procedure, but also in maintaining skills and preparing for the management of complications. For these purposes, mechanical simulators will definitely play an important role in the future.
Rassweiler
Jens
J
Department of Urology, Klinikum Heilbronn, University of Heidelberg, Heidelberg, Germany. jens.rassweiler@slk-kliniken.de
Klein
Jan
J
Teber
Dogu
D
Schulze
Michael
M
Frede
Thomas
T
D000818:Animals; D003198:Computer Simulation; D018961:Educational Technology / Q000295:instrumentation*; D004867:Equipment Design; D006801:Humans; D010535:Laparoscopy; D013520:Urologic Surgical Procedures / Q000193:education*; D014572:Urology / Q000193:education; D014584:User-Computer Interface