title: Homemade laparoscopic surgical simulator: a cost-effective solution to the challenge of acquiring laparoscopic skills?
abstract: BACKGROUND
  Laparoscopic surgery is well known to have a long and variable learning curve and there is a potential benefit from earlier integration of laparoscopic skills in medical education.
  
  
  OBJECTIVE
  The aim of this study was to assess the challenges facing surgical trainees regarding the acquisition of laparoscopic skills and second to assess their opinion regarding the use of a homemade laparoscopic surgical simulator.
  
  
  METHODS
  A homemade laparoscopic surgical simulator (HLSS) was constructed. An online survey using Survey Monkey®of surgical trainees at a tertiary referral university teaching hospital was conducted assessing their experience with laparoscopic surgery. Surgical trainees were voluntarily enrolled to assess the self-designed laparoscopic trainer. Each trainee was asked to perform simple exercises without supervision.
  
  
  RESULTS
  All trainees (n = 34) responded to the survey. No trainee had full-time access to a laparoscopic box trainer. The mean time spent per week using the simulator was 0.38 h (range 0-3 h), with 61.8 % (n = 21) reporting not using the simulator at all. 94.1 % (n = 32) enrolled in our study. 90.6 % (n = 29) found the HLSS easy to use compared to 93.8 % (n = 30) with the CLS (p = 1.00). 96.9 % (n = 31) reported an overall satisfaction with the HLSS. There was no difference with regard to the completing the tasks: peg transfer (78.1 vs 78.1 %, p = 1.00), cutting patterns (65.6 vs 71.9 %, p = 0.788) or knot tying (12.5 vs 18.8 %, p = 0.732) whether using HLSS and the CLS.
  
  
  CONCLUSIONS
  Homemade laparoscopic surgical simulators are easy to construct, affordable, usable and of interest to trainees.
authors.affiliation: Department of Urology, University Hospital Limerick, Dooradoyle, Limerick, Ireland.
authors.forename: A
authors.initials: A
authors.lastname: Aslam
authors.affiliation: Department of Urology, University Hospital Limerick, Dooradoyle, Limerick, Ireland. nasong@tcd.ie.
authors.forename: G J
authors.initials: GJ
authors.lastname: Nason
authors.affiliation: Department of Urology, University Hospital Limerick, Dooradoyle, Limerick, Ireland.
authors.forename: S K
authors.initials: SK
authors.lastname: Giri
mesh_terms: D000328:Adult; D002983:Clinical Competence; D004501:Education, Medical / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000193:education*; D059032:Learning Curve; D008297:Male; D000066908:Simulation Training / Q000379:methods*; D055815:Young Adult
keywords: Box trainers; Laparoscopy; Simulation; Surgical training