title: Structuralized box-trainer laparoscopic training significantly improves performance in complex virtual reality laparoscopic tasks.
abstract: BACKGROUND
  In the era of flowering minimally invasive surgical techniques there is a need for new methods of teaching surgery and supervision of progress in skills and expertise. Virtual and physical box-trainers seem especially fit for this purpose, and allow for improvement of proficiency required in laparoscopic surgery.
  
  
  METHODS
  The study included 34 students who completed the authors' laparoscopic training on physical train-boxes. Progress was monitored by accomplishment of 3 exercises: moving pellets from one place to another, excising and clipping. Analysed parameters included time needed to complete the exercise and right and left hand movement tracks. Students were asked to do assigned tasks prior to, in the middle and after the training.
  
  
  RESULTS
  The duration of the course was 28 h in total. Significant shortening of the time to perform each exercise and reduction of the left hand track were achieved. The right hand track was shortened only in exercise number 1.
  
  
  CONCLUSIONS
  Exercises in the laboratory setting should be regarded as an important element of the process of skills acquisition by a young surgeon. Virtual reality laparoscopic training seems to be a new, interesting educational tool, and at the same time allows for reliable control and assessment of progress.
authors.affiliation: Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Poland.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Laski
authors.forename: Tomasz J
authors.initials: TJ
authors.lastname: Stefaniak
authors.forename: Wojciech
authors.initials: W
authors.lastname: Makarewicz
authors.forename: Monika
authors.initials: M
authors.lastname: Proczko
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Gruca
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Sledziński