Authors:   F.Mandolfino, M.Sguanci, M.Minuto, G.Vercelli, G.Marcocci, M.Frascio

Abstract

INTRODUCTION. To present the University of Genoa Advanced Simulation Center (ASC) and the design a trainer (eLap4D) that would achieve the equivalent goals of the fundamentals of laparoscopic surgery trainer at an economical cost. The validation process is going to be shown too. METHODS. The laparoscopic trainer is a physical low-cost laparoscopic training platform that reproduces the tactile feedback (eLaparo4d) integrated with a software for virtual anatomical realistic scenarios (Unity3D V 4.1). A sample of 20 students was selected, divided into 2 homogeneous groups with respect to the level of confidence with the use of video games, consolles, smartphones (this has been possible thanks to the use of a questionnaire, administered before the practical phase of training). The groups participated in a training program based on 5 basic laparoscopic skills (laparoscopic focusing and navigation, hand â?? eye â?? coordination and grasp coordination). So, a second and third study sample was chosen, consisting of 20 post graduate students (intermediate group) and 20 experienced surgeons; for theese groups was provided a training program identical to the previous group as well as their subdivision into 2 group. The face validity was used for an ergonomic analysis of the simulator, the construct to test the system's ability to differentiate potential expert users (experienced surgeons) from non-experts (student without experience in laparoscopic surgery). RESULTS. We analyzed the results of the three samples obtained by comparing variables such as: score % of fullfillment panality time At the same time, the studentsâ?? improvements have been monitored, developing a customized learning curve for each user. To evaluate the structural characteristics of the simulator a specific questionnaire has been used. The results encouraged us. The simulator is ergonomically satisfactory and its structural features are adapted to the training. The system was able to differentiate the level of experience and also has therefore met the requirements of "construct validity". CONCLUSION. Valid laparoscopic simulators can be constructed at an economical cost.