Ethan Alford
Introduction
Day surgery depends on efficient, safe laparoscopic practice delivered by surgeons who achieve technical competence early in training. Reduced operative exposure and service pressures challenge traditional training models. Virtual reality (VR) simulation offers an immersive, scalable, and reproducible approach to laparoscopic skills training, with potential to improve preparedness for day surgery.
Methods
A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Embase, and the Cochrane Library were searched from January 2010 onwards. Eligible studies included surgical trainees undertaking laparoscopic surgery training using VR simulation, compared with conventional methods including box trainers and standard curricula. Outcomes assessed included Objective Structured Assessment of Technical Skills (OSATS), Global Operative Assessment of Laparoscopic Skills (GOALS), task completion time, and error rates. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool, and certainty of evidence using Grading of Recommendations, Assessment, Development and Evaluations principles (GRADE).
Results
Thirty-seven studies demonstrated consistent benefits of VR training. Task completion time improved by 10-40%, error rates were reduced by up to 50%, and validated technical performance scores showed moderate-to-large improvements. Several studies demonstrated skill retention for up to 16 weeks. Enhanced feedback modalities, including three-dimensional (3-D) vision, were associated with further gains in efficiency, accuracy, and trainee confidence.
Conclusions
VR-based training accelerates laparoscopic skill acquisition, reduces errors, and improves readiness for independent practice. These findings support integration of VR simulation into national surgical training pathways to improve efficiency, safety, and standardisation in day surgery.
Authors
Ethan Alford, Sophie Hong, Gareth Chionh, Amr Metwalli
University Hospital Southampton Faculty of Medicine, United Kingdom