Towards virtual FLS: development of a peg transfer simulator.

Background: Peg transfer is one of five tasks in the Fundamentals of Laparoscopic Surgery (FLS), program. This paper reports the development and validation of a Virtual Basic Laparoscopic Skill Trainer-Peg Transfer (VBLaST-PT(©) ) simulator for automatic real-time scoring and objective quantification of performance.

Methods: New techniques have been introduced in order to allow bi-manual manipulation of pegs and automatic scoring/evaluation while maintaining high quality of simulation. A preliminary face and construct validation study was performed with 22 subjects divided into two groups: experts (PGY 4-5, fellow and practicing surgeons) and novice (PGY 1-3).

Results: Face validation shows high scores for all aspects of the simulation. Two-tailed Mann-Whitney U-test scores showed significant differences between the two groups on completion time (P = 0.003), FLS score (P =0.002) and the VBLaST-PT© score (P = 0.006).

Conclusions: VBLaST-PT(©) is a high quality virtual simulator that showed both face and construct validity.