The use of simulation in the acquisition of laparoscopic suturing skills

OBJECTIVE: Laparoscopic suturing is recognised as one of the most difficult laparoscopic skills to master. With the use of simulation increasing in the training of future surgeons, a comprehensive literature review was carried out to evaluate the current evidence for the role of simulators in facilitating the acquisition of this particular skill. METHOD: A PubMed search was performed using terms 'laparoscopy', 'suturing', and 'simulation'. The resulting literature was then analysed for relevance and summarised. RESULTS: A total of 68 relevant articles were found and evaluated; despite the relatively small sample size in most studies, simulation has been proven to provide an effective method for the tuition of surgical trainees in laparoscopic suturing. Furthermore, the skills acquired through simulator training appear to be successfully transferable to the operating room environment. Simulators have also shown potential as valuable tools in the assessment of proficiency in trainees, with their evaluation of individuals correlating well with expert observer ratings in complex laparoscopic tasks such as suturing. Questions regarding the type of simulator to be used, the nature of the training curriculum, and how such a curriculum can practically be integrated into current surgical training programmes remain to be answered. CONCLUSIONS: Simulation is an integral tool in the training of future laparoscopic surgeons, and further research is required to answer the question of how to maximise benefit from these invaluable training implements.