A study comparing virtual reality simulation, 3D printed organ models and a combination of both for laparoscopy surgery skills acquisition.

OBJECTIVE

Virtual reality (VR) simulators and 3D printed organ models are effective for laparoscopic skill acquisition independently. This study aimed to evaluate the synergistic efficacy of a hybrid training program that combines both modalities.

METHODS

Twenty-seven surgical novices, were randomized into three equal cohorts (VR, 3D, Hybrid). The hybrid cohort underwent a two-phase curriculum over 10 weeks: VR simulation for weeks 1-5, followed by the 3D model for weeks 6-10. The final task was a laparoscopic colon end-to-end anastomosis on a porcine ex vivo model, which was video-recorded for blinded OSATS assessment. Primary outcomes included OSATS scores and procedure times. Data were analyzed using ANOVA, Chi-square test, Kruskal-Wallis H test, and post hoc tests. Learning curves were assessed using CUSUM analysis, and survey data were analyzed with Wilcoxon signed-rank and Mann-Whitney U tests.

RESULTS

OSATS scores: Hybrid vs. 3D vs. VR (30.67 ± 3.464 vs. 29.00 ± 3.640 vs. 24.78 ± 2.99, P < 0.01). Procedure times were similar across groups: VR (120.33 ± 51.42 min), 3D (119.56 ± 34.04 min), Hybrid (135 ± 25.08 min). Fluid leak test: VR group showed significantly higher fluid leakage and fluid leakage flow rate than hybrid and 3D (p < 0.05). Learning curve: Hybrid had shorter curve. Instrument handling: 3D and Hybrid outperformed VR (p < 0.05). Post-training surveys: 3D and Hybrid groups reported improvements in interest in surgery and confidence in laparoscopic skills (p < 0.05). 3D cohort rated highest in confidence building, realism, and overall effectiveness (p < 0.01).

CONCLUSION

A hybrid curriculum enhances training outcomes compared to a VR-only curriculum, with 3D models showing particular strengths in optimizing skill acquisition. Integrating 3D printed models into a hybrid curriculum may shorten the learning curve and better prepare trainees for complex surgical tasks, expanding access to effective laparoscopic training.