Effect of a structured virtual reality simulation curriculum on laparoscopic performance in a porcine cholecystectomy model: a prospective comparative study.

BACKGROUND

Virtual reality simulation training (VRST) has been shown to improve laparoscopic skills; however, evidence for structured simulation curricula remains limited. This study aimed to prospectively assess the effect of a structured VRST curriculum on laparoscopic performance in a porcine cholecystectomy model in novice surgeons.

METHODS

In this single-blinded prospective study, novice surgical trainees (< 3 years of clinical experience) attending a basic laparoscopic course were allocated to either a structured, proficiency-based VRST curriculum or standard deliberate practice on the same simulator. Laparoscopic performance was assessed during a porcine laparoscopic cholecystectomy (Lap-C) by blinded raters using the Global Operative Assessment of Laparoscopic Skills (GOALS) and a numerical rating scale (NRS).

RESULTS

Seventy-one participants were analyzed (19 intervention, 52 control). Trainees completing the structured VRST achieved significantly higher total GOALS scores compared with controls (median 17.6 vs. 14.0; p = 0.013). All GOALS subdomains -including depth perception, bimanual dexterity, efficiency, tissue handling, and autonomy-were significantly improved in the intervention group. Subjective performance ratings were also higher following structured VRST (median NRS 6.7 vs. 4.8; p = 0.036). Inter-rater reliability for the GOALS score was good (ICC = 0.80).

CONCLUSION

Participation in a structured VR simulation curriculum improved laparoscopic performance during a standardized porcine cholecystectomy model post-test compared with deliberate practice. Integration of structured VRST curricula into surgical training programs may enhance early technical skill acquisition and procedural proficiency.