title: Porcine cadaver organ or virtual-reality simulation training for laparoscopic cholecystectomy: a randomized, controlled trial.
abstract: OBJECTIVE
  As conventional laparoscopic procedural training requires live animals or cadaver organs, virtual simulation seems an attractive alternative. Therefore, we compared the transfer of training for the laparoscopic cholecystectomy from porcine cadaver organs vs virtual simulation to surgery in a live animal model in a prospective randomized trial.
  
  
  METHODS
  After completing an intensive training in basic laparoscopic skills, 3 groups of 10 participants proceeded with no additional training (control group), 5 hours of cholecystectomy training on cadaver organs (= organ training) or proficiency-based cholecystectomy training on the LapMentor (= virtual-reality training). Participants were evaluated on time and quality during a laparoscopic cholecystectomy on a live anaesthetized pig at baseline, 1 week (= post) and 4 months (= retention) after training.
  
  
  METHODS
  All research was performed in the Center for Surgical Technologies, Leuven, Belgium.
  
  
  METHODS
  In total, 30 volunteering medical students without prior experience in laparoscopy or minimally invasive surgery from the University of Leuven (Belgium).
  
  
  RESULTS
  The organ training group performed the procedure significantly faster than the virtual trainer and borderline significantly faster than control group at posttesting. Only 1 of 3 expert raters suggested significantly better quality of performance of the organ training group compared with both the other groups at posttesting (p < 0.01). There were no significant differences between groups at retention testing. The virtual trainer group did not outperform the control group at any time.
  
  
  CONCLUSIONS
  For trainees who are proficient in basic laparoscopic skills, the long-term advantage of additional procedural training, especially on a virtual but also on the conventional organ training model, remains to be proven.
authors.affiliation: Center for Surgical Technologies, Leuven, Belgium; Department of Urology, University Hospitals Leuven, Leuven, Belgium. Electronic address: siska.vanbruwaene@gmail.com.
authors.forename: Siska
authors.initials: S
authors.lastname: Van Bruwaene
authors.affiliation: Department of Surgery, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
authors.forename: Marlies P
authors.initials: MP
authors.lastname: Schijven
authors.affiliation: Universidad Catolica de Cordoba, Córdoba, Argentina.
authors.forename: Daniel
authors.initials: D
authors.lastname: Napolitano
authors.affiliation: Center for Surgical Technologies, Leuven, Belgium; Department of Urology, University Hospitals Leuven, Leuven, Belgium; Department of Urology, University Hospitals Antwerp, Edegem, Belgium.
authors.forename: Gunter
authors.initials: G
authors.lastname: De Win
authors.affiliation: Center for Surgical Technologies, Leuven, Belgium; Department of Abdominal Surgery, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: Miserez
mesh_terms: D000818:Animals; D001530:Belgium; D002102:Cadaver; D017081:Cholecystectomy, Laparoscopic / Q000193:education*; D002983:Clinical Competence; D003194:Computer-Assisted Instruction; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement; D006801:Humans; D023421:Models, Animal; D011446:Prospective Studies; D000066908:Simulation Training; D013552:Swine; D014584:User-Computer Interface
keywords: LapMentor; Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; cadaver organ; cholecystectomy; porcine; training; virtual reality