Combining traditional laparoscopic box practice with video gaming: A randomized control trial

While there is consensus regarding a positive effect of video gaming on dexterity, little is known regarding how much traditional laparoscopic practice can or should be substituted with video gaming. This study was designed to assess the effects of varying the amount of traditional practice in a lap box trainer and video gaming on performance in two fundamentals of laparoscopic surgery (FLS) core tasks. Undergraduate and medical students were recruited and randomized into one of four groups: a control group, a lap box group, a video game group, and a combined group with 50% of the time allocated to each modality. Performance in the two FLS tasks was assessed both prior to and following the 6 training sessions. Peg transfer performance significantly improved in the lap box group (168.4 ± 70.6 s vs. 332.9 ± 178.2 s, p < 0.001), video game group (176.7 ± 53.3 s vs. 300.0 ± 101.2 s, p < 0.001) and combined group (214.2 ± 86.9 s vs. 406.8 ± 239.5 s, p = 0.002) after training. Similar improvements were also observed in precision cutting performance in the lap box group (413.1 ± 138.4 s vs. 614.3 ± 211.4 s, p = 0.002), video game group (434.1 ± 150.8 s vs. 609.2 ± 233.2 s, p = 0.007) and combined group (469.2 ± 185.3 s vs. 663.8 ± 296.3 s, p = 0.020). When analyzing improvements in performance across three different training groups compared with the control group, we found that both the laparoscopic box group ( p < 0.001) and the combined group ( p < 0.001) showed better improvement in both tasks, and the video game group had significantly better outcomes in the precision cutting task ( p = 0.003). Traditional lap box training remains the most effective method for improving the performance of simulated laparoscopic surgery. Video games can be encouraged to enhance skills retention and supplement simulated practice outside of a formal training curriculum.