title: 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.
  
  
  OBJECTIVE
  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.
authors.affiliation: Department of Urology, Lancashire Teaching Hospitals NHS Trust, Fulwood, Preston PR2 9HT, UK. parassingh@btinternet.com
authors.forename: Paras B
authors.initials: PB
authors.lastname: Singh
authors.forename: Ngiaw K
authors.initials: NK
authors.lastname: Saw
authors.forename: Moeketsi
authors.initials: M
authors.lastname: Mokete
authors.forename: Francis L
authors.initials: FL
authors.lastname: Martin
authors.forename: Shyam S
authors.initials: SS
authors.lastname: Matanhelia
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003198:Computer Simulation; D018961:Educational Technology / Q000295:instrumentation*; D004867:Equipment Design; D006801:Humans; D010535:Laparoscopy; D008348:Manikins; D010865:Pilot Projects; D011795:Surveys and Questionnaires; D006113:United Kingdom; D014584:User-Computer Interface