Authors:   E.Perino, M. Sguanci, F. Mandolfino, M. Minuto, G. Vercelli, M. Gaudina, S. Marcutti, V. Rumolo, G. Marcocci, M. Frascio

Abstract

The use of simulation in laparoscopic surgery training appears to be qualitatively effective if supported by a suitable evaluation system. The increasing demand of more complex laparoscopic simulators has inspired the creation of a 4d simulator which 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). The aim of the present project is to show the validation process results of this system using two instruments: the face validity and the construct validity. The face validity was used for an ergonomic analysis of the simulator, the construct to test the system's ability to differentiate expert users (experienced surgeons in laparoscopy) from non-experts (student without experience in laparoscopic surgery). 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 in laparoscopy; for theese groups was provided a training program identical to the previous group as well as their subdivision into 2 group. We analyzed the results of the three samples obtained by comparing variables such as: score % of fullfillment panality time At the same time, the students improvements has been monitorized, 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".