A Cochrane review [Abstract] 1 included 23 studies with a total of 612 participants comparing virtual reality versus video trainer training (4 trials); virtual reality versus no training or standard laparoscopic training (12 trials); virtual reality, video trainer training and no training, or standard laparoscopic training (4 trials); and different methods of virtual reality training (3 trials).
In trainees without prior surgical laparoscopic experience, virtual reality training decreased the time taken to complete a task (SMD -1.09; 95% CI -1.50 to -0.68; 5 trials 119 participants), increased accuracy, and decreased errors (SMD 0.5, 95% CI 0.00 to 0.99; 3 trials 73 participants) compared with no training. Virtual reality group was more accurate than video trainer training group (SMD 0.68 95% Cl 0.05 to 1.31; 1 trial 41 participants).
In the participants with limited laparoscopic experience, virtual reality training reduced operating time and error better than standard in the laparoscopic training group; composite operative performance score was better in the virtual reality group than in the video trainer group.
Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment) and by indirectness (lack of patient-oriented outcomes).
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