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Copyright ©The Author(s) 2015.
World Journal of Gastrointestinal Surgery. Sep 27, 2015; 7(9): 185-189
Published online Sep 27, 2015. doi: 10.4240/wjgs.v7.i9.185
Table 1 Distinctive features and challenges of laparoscopic surgery[20]
FeaturesChallenges
Two dimensional visionReduced perception of depth
A disturbed eye-hand-target axisDecreases ergonomy and dexterity
Long and inflexible instrumentsNatural hand tremor magnified
Rigid instruments with five degrees of freedomDecreased dexterity and range of motion
Fixed abdominal entry pointsLimited freedom of motion and movement of the instrument: The fulcrum effect
Camera instabilityIncreased fatigue
Limited tactile feedbackDecreases dexterity
Table 2 Characteristics of the different types of simulators
Type of simulatorMain features
Box trainersLow-cost, portable, can be used repatedly by multiple users. Used to teach basic laparoscopic skills: hand-eye coordination, cutting, suturing, bimanual dexterity. Provide sensory feedback
Requires direct observation and supervision by a trainer
Virtual reality simulatorsRecord several procedure metrics providing feedback to trainees. Recording of training performance for objective evidence of skill performance. Minor degree of sensory feedback and higher initial are the main disadvantages
Hybrid modelsReduced costs compared to cadaveric models. Questionable value of a training model with an alternative structure
Animal and human cadaveric modelsBest anatomic and clinical-like model. Avaibility is limited and their use is expensive. Require operative facilities and a funeral service