title: Faster acquisition of laparoscopic skills in virtual reality with haptic feedback and 3D vision.
abstract: BACKGROUND
  The study investigated whether 3D vision and haptic feedback in combination in a virtual reality environment leads to more efficient learning of laparoscopic skills in novices.
  
  
  METHODS
  Twenty novices were allocated to two groups. All completed a training course in the LapSim®virtual reality trainer consisting of four tasks: 'instrument navigation', 'grasping', 'fine dissection' and 'suturing'. The study group performed with haptic feedback and 3D vision and the control group without. Before and after the LapSim®course, the participants' metrics were recorded when tying a laparoscopic knot in the 2D video box trainer Simball®Box.
  
  
  RESULTS
  The study group completed the training course in 146 (100-291) minutes compared to 215 (175-489) minutes in the control group (p = .002). The number of attempts to reach proficiency was significantly lower. The study group had significantly faster learning of skills in three out of four individual tasks; instrument navigation, grasping and suturing. Using the Simball®Box, no difference in laparoscopic knot tying after the LapSim®course was noted when comparing the groups.
  
  
  CONCLUSIONS
  Laparoscopic training in virtual reality with 3D vision and haptic feedback made training more time efficient and did not negatively affect later video box-performance in 2D. [Formula: see text].
authors.affiliation: a Practicum Clinical Skills Center, Skåne University Hospital , Lund , Sweden.|b Department of Clinical Sciences, Surgery , Lund University, Skåne University Hospital , Lund , Sweden.
authors.forename: Kristine
authors.identifier: http://orcid.org/0000-0002-6843-8995
authors.initials: K
authors.lastname: Hagelsteen
authors.affiliation: a Practicum Clinical Skills Center, Skåne University Hospital , Lund , Sweden.
authors.forename: Anders
authors.identifier: http://orcid.org/0000-0002-2219-8164
authors.initials: A
authors.lastname: Langegård
authors.affiliation: a Practicum Clinical Skills Center, Skåne University Hospital , Lund , Sweden.
authors.forename: Adam
authors.identifier: http://orcid.org/0000-0001-8599-6350
authors.initials: A
authors.lastname: Lantz
authors.affiliation: a Practicum Clinical Skills Center, Skåne University Hospital , Lund , Sweden.|c Department of Clinical Sciences, Surgery , Lund University, Skåne University Hospital , Malmö , Sweden.
authors.forename: Mikael
authors.identifier: http://orcid.org/0000-0003-3309-6398
authors.initials: M
authors.lastname: Ekelund
authors.affiliation: a Practicum Clinical Skills Center, Skåne University Hospital , Lund , Sweden.|d Department of Clinical Sciences, Paediatrics , Lund University, Skåne University Hospital , Lund , Sweden.
authors.forename: Magnus
authors.identifier: http://orcid.org/0000-0002-4505-338X
authors.initials: M
authors.lastname: Anderberg
authors.affiliation: a Practicum Clinical Skills Center, Skåne University Hospital , Lund , Sweden.|b Department of Clinical Sciences, Surgery , Lund University, Skåne University Hospital , Lund , Sweden.
authors.forename: Anders
authors.identifier: http://orcid.org/0000-0002-8355-6025
authors.initials: A
authors.lastname: Bergenfelz
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003198:Computer Simulation; D004504:Education, Medical, Undergraduate; D005260:Female; D000068156:Formative Feedback; D006801:Humans; D021621:Imaging, Three-Dimensional; D010535:Laparoscopy / Q000193:education*; D008297:Male; D016037:Single-Blind Method; D013997:Time Factors; D000076142:Virtual Reality; D055815:Young Adult
keywords: 3D vision; Haptic feedback; laparoscopy; surgical education; virtual reality