medigraphic.com
ISSN 1665-2576 (Print)

2026, Number 1-2

<< Back Next >>

Rev Mex Cir Endoscop 2026; 27 (1-2)

Impact of surgical simulation on undergraduate and postgraduate students

Montalvo-Javé EE, Vilchis-Valencia R, Jiménez-Recillas D, Rodríguez-Mendoza G, Martínez-Hernández O, Romero-Carrillo R, Cruz-Alcántara C, Rossano-García A, García-Puig MA, Santana-Domínguez MD, Nuño-Lámbarri N, Rodríguez-Báez A, Miranda-Galván V

Language: Spanish
References: 31
Page: 25-32
PDF size: 448.11 Kb.


ABSTRACT

Laparoscopic simulation has become a cornerstone in surgical training, enabling the development of technical skills in a safe and controlled environment. This review aimed to analyze current evidence regarding different types of simulators, evaluation metrics, and their ability to predict real surgical performance. A narrative literature review was conducted using international databases, including studies published between 2001 and 2025. Simulators were classified into five main categories: conventional physical trainers, virtual reality simulators, hybrid systems, biological models, and platforms with automated performance metrics. The findings indicate that all modalities significantly contribute to the acquisition of fundamental skills such as hand-eye coordination, precision, and movement efficiency. However, virtual reality and hybrid systems offer advantages in providing objective and reproducible performance metrics. Commonly used metrics include task completion time, error rate, and motion economy; however, their predictive value is limited when used in isolation. In contrast, combining these objective metrics with structured assessment tools such as GOALS and OSATS provides a more comprehensive evaluation and shows stronger correlation with intraoperative performance. In conclusion, the effectiveness of laparoscopic simulation depends more on its integration into structured training programs and the use of validated assessment tools than on the level of technological fidelity. Future research should focus on metric standardization and validation of clinical outcomes.


REFERENCES

  1. Grantcharov TP, Kristiansen VB, Bendix J, Bardram L, Rosenberg J, Funch-Jensen P. Randomized clinical trial of virtual reality simulation for laparoscopic skills training. Br J Surg. 2004; 91: 146-150.

  2. Lorias-Espinoza D, Díaz-Cardona SK, Sánchez-Velasco LE, Ordorica-Flores RM, Minor-Martínez A, Montoya-Alvarez S et al. Skills assessment for laparoscopic surgery based on computer analysis metrics: ScopePro Trainer. Surg Endosc. 2025; 39: 6449-6458.

  3. Valadez-Caballero D, Urbina-Cabello JJ, Salinas-Ocampo C, Alvarado-Durán J, Cristóbal-Luna JM. Utilidad del simulador de habilidades en el entrenamiento estructurado de procedimientos laparoscópicos. Rev Mex Cir Endoscop. 2025; 26: 9-17.

  4. Thuler FR, de Freitas WR Jr, Ilias EJ, Kassab P, Malheiros CA. Laparoscopic bariatric surgery training program model: gastric bypass. BMC Surg. 2014; 14: 101. doi: 10.1186/1471-2482-14-101.

  5. Enciso SS, Sánchez MFM, Díaz-Güemes MPI, Usón GJ. Validación preliminar del simulador físico Simulap® y de su sistema de evaluación para cirugía laparoscópica. Cir Esp. 2011; 90: 38-44.

  6. Thomaschewski M, Vonthein R, Keck T, Laubert T, Benecke C; NOVICE study group. Laparoscopic simulation training improves operating room performance of surgical residents: a multicenter randomized trial (NOVICE). Int J Surg. 2025; 111: 2923-2932.

  7. Selva RDR, Kumar S, Nallathamby K, Raj K, Hristova M. A systematic review of the learning curves of novices and trainees to achieve proficiency in laparoscopic skills: virtual reality simulator versus box trainer. Cureus. 2024; 16: e72923. doi: 10.7759/cureus.72923.

  8. Seeger P, Kaldis N, Nickel F, Hackert T, Lykoudis PM, Giannou AD. Surgical training simulation modalities in minimally invasive surgery: how to achieve evidence-based curricula by translational research. Am J Surg. 2025; 242: 116197.

  9. Sroka G, Feldman LS, Vassiliou MC, Kaneva PA, Fayez R, Fried GM. Fundamentals of laparoscopic surgery simulator training to proficiency improves laparoscopic performance in the operating room-a randomized controlled trial. Am J Surg. 2010; 199: 115-120.

  10. Heredia-Montaño M, Díaz-Barrientos CZ, Padilla-Gómez CI, Navarro-Tovar F, Hernández-Pérez E, Rivas-Chávez AE. Comparación de las habilidades básicas en laparoscopía antes y después de la realización de un programa de entrenamiento en residentes de cirugía general del Hospital General Zona Norte de Puebla. Rev Hosp Jua Mex. 2022; 89: 55-60. doi: 10.24875/RHJM.21000031.

  11. Pérez-Escamirosa F, Nuñez-Rojas AN, Dorantes-Nava CL, Montoya-Alvarez S, Sánchez-Margallo JA, Oropesa I et al. Effect of three training programs on surgical performance in single-port laparoscopic surgery. Cir Cir. 2024; 92: 194-204.

  12. Haskins IN, Tan WH, Zaman J, Alimi Y, Awad M, Giorgi M et al. Current status of resident simulation training curricula: pearls and pitfalls. Surg Endosc. 2024; 38: 4788-4797.

  13. Roberts KE, Bell RL, Duffy AJ. Evolution of surgical skills training. World J Gastroenterol. 2006; 12: 3219-3224.

  14. Villegas L, Schneider BE, Callery MP, Jones DB. Laparoscopic skills training. Surg Endosc. 2003; 17: 1879-1888.

  15. Lucas S, Tuncel A, Bensalah K, Zeltser I, Jenkins A, Pearle M et al. Virtual reality training improves simulated laparoscopic surgery performance in laparoscopy naïve medical students. J Endourol. 2008; 22: 1047-1051.

  16. Vanderbilt AA, Grover AC, Pastis NJ, Feldman M, Granados DD, Murithi LK et al. Randomized controlled trials: a systematic review of laparoscopic surgery and simulation-based training. Glob J Health Sci. 2014; 7: 310-327.

  17. Al-Kadi AS, Donnon T, Oddone PE, Mitchell P, Debru E, Church N. The effect of simulation in improving students' performance in laparoscopic surgery: a meta-analysis. Surg Endosc. 2012; 26: 3215-3224.

  18. Erlich-Feingold O, Anteby R, Klang E, Soffer S, Cordoba M, Nachmany I et al. Artificial intelligence classifies surgical technical skills in simulated laparoscopy: a pilot study. Surg Endosc. 2025; 39: 3592-3599.

  19. Von Websky MW, Vitz M, Raptis DA, Rosenthal R, Clavien PA, Hahnloser D. Basic laparoscopic training using the Simbionix LAP Mentor: setting the standards in the novice group. J Surg Educ. 2012; 69: 459-467.

  20. Seymour NE, Gallagher AG, Roman SA, O'Brien MK, Bansal VK, Andersen DK, Satava RM. Virtual reality training improves operating room performance: results of a randomized, double-blinded study. Ann Surg. 2002; 236: 458-463; discussion 463-464.

  21. McClusky DA, Gallagher AG, Ritter ME, Lederman AB, Van Sickle KR, Baghai M, et al. Virtual reality training improves junior residents' operating room performance: results of a prospective, randomized, double-blinded study of the complete laparoscopic cholecystectomy. J Am Coll Surg. 2004; 199: 73.

  22. Moulder JK, Louie M, Toubia T, Schiff LD, Siedhoff MT. The role of simulation and warm-up in minimally invasive gynecologic surgery. Curr Opin Obstet Gynecol. 2017; 29: 212-217.

  23. Popa C, Abdul HN, Pestean C, Ober C, Elisei R, Al Momani T, Schlanger D, Graur F et al. Residents can do it! A training program in laparoscopic liver surgery for general surgery residents. Eur Surg Res. 2023; 64: 237-245.

  24. Andreatta PB, Woodrum DT, Birkmeyer JD, Yellamanchilli RK, Doherty GM, Gauger PG et al. Laparoscopic skills are improved with LapMentor training: results of a randomized, double-blinded study. Ann Surg. 2006; 243: 854-860; discussion 860-863.

  25. De Wilde RL, Herrmann A. Robotic surgery - advance or gimmick? Best Pract Res Clin Obstet Gynaecol. 2013; 27: 457-469.

  26. Bresler L, Perez M, Hubert J, Henry JP, Perrenot C. Residency training in robotic surgery: the role of simulation. J Visc Surg. 2020; 157: S123-129.

  27. Hiraki M, Kimura N, Kitagawa H, Kohya N, Samejima R. Laparoscopic training for gastrointestinal surgery using japanese traditional papercraft origami. Surg Laparosc Endosc Percutan Tech. 2022; 32: 401-403.

  28. Meling TR, Meling TR. The impact of surgical simulation on patient outcomes: a systematic review and meta-analysis. Neurosurg Rev. 2021; 44: 843-854.

  29. Dubuisson J, Vilmin F, Boulvain M, Combescure C, Petignat P, Brossard P. Do laparoscopic pelvic trainer exercises improve residents' surgical skills? A randomized controlled trial. Eur J Obstet Gynecol Reprod Biol. 2016; 206: 177-180.

  30. Mohamadipanah H, Perrone KH, Nathwani J, Parthiban C, Peterson K, Wise B et al. Screening surgical residents' laparoscopic skills using virtual reality tasks: Who needs more time in the sim lab? Surgery. 2019; 166: 218-222.

  31. Jokinen E, Mikkola TS, Harkki P. Effect of structural training on surgical outcomes of residents' first operative laparoscopy: a randomized controlled trial. Surg Endosc. 2019; 33: 3688-3695.




2020     |     www.medigraphic.com