Application of animal organ models in laparoscopic surgery training: a systematic review.

BACKGROUND

Animal organ models are increasingly used in laparoscopic training; however, their educational effectiveness and optimal application have yet to be synthesized. This systematic review aimed to review the evidence for application and effectiveness of animal organ models in laparoscopic training.

METHODS

MEDLINE, Scopus and Cochrane Library were searched from inception up to May 23, 2026, following PRISMA guidelines. Studies evaluating animal organ models for laparoscopic technical skills training were included. Study quality was assessed using the Medical Education Research Study Quality Instrument (MERSQI). Data on model characteristics (anatomical and physiological realism), training protocols, assessment tools, and educational outcomes were extracted.

RESULTS

A total of 56 studies were included, involving 2025 participants across six specialties. Based on anatomical and physiological realism of animal organ models, three fidelity levels were identified: low (15 studies, mainly in urology), medium (37 studies, across multiple specialties), and high (ex vivo perfused, 11 studies, mainly for resection procedures). Of the 56 studies, 4 assessed training impact using only self-reported questionnaires, 41 measured impact by change in learner knowledge and skill in teaching scenario, and 12 provided evidence of clinical skill transfer (21%), of which 5 only evaluated behavior change in workplace using objective parameters or rating scales, and 7 measured patient outcomes simultaneously. Only one study explicitly reported Institutional Animal Care and Use Committee (IACUC) approval.

CONCLUSIONS

Animal organ models provide fidelity‑dependent educational value across laparoscopic training stages. Low‑fidelity models support novices in acquiring fundamental psychomotor skills; medium‑fidelity models facilitate procedure‑specific training in intermediates within realistic anatomy; and high‑fidelity perfused models prepare advanced trainees for intraoperative crisis management. However, evidence for clinical transfer and ethical reporting remains limited.