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To present the University of Genoa Advanced Simulation Center (SimAv) and the project of a trainer (eLap4D) that would achieve the equivalent goals of the fundamentals of laparoscopic surgery trainer at an economical cost. The validation process is going to be shown too. METHODS. The laparoscopic trainer is a physical low-cost laparoscopic training platform that reproduces the tactile feedback (eLaparo4d) integrated with a software for virtual anatomical realistic scenarios (Unity3D V 4.1). A sample of 20 students was selected, divided into 2 homogeneous groups with respect to the level of confidence with the use of video games, consoles, smartphones (this has been possible thanks to the use of a questionnaire, administered before the practical phase of training). The groups participated in a training program based on 5 basic laparoscopic skills (laparoscopic focusing and navigation, hand – eye – coordination and grasp coordination). So, a second and a third study sample was chosen, consisting of 20 post graduate students (intermediate group) and 20 experienced surgeons; for these groups a training program was provided, identical to the previous group as well as their subdivision into 2 group. The face validity was used for an ergonomic analysis of the simulator, the construct to test the system's ability to differentiate potential expert users (experienced surgeons) from non-experts (student without experience in laparoscopic surgery). The authors analyzed the results of the three samples obtained by comparing variables such as score, % of fulfillment, panality and time. At the same time, the students' improvements have been monitored, developing a customized learning curve for each user. To evaluate the structural characteristics of the simulator a specific questionnaire has been used. The results were encouraging. The simulator is ergonomically satisfactory and its structural features are adapted to the training. The system was able to differentiate the level of experience and also has therefore met the requirements of “construct validity”. laparoscopic simulators can be constructed at an economical cost.

The aim of this study is to investigate the importance of acquiring basic and advanced laparoscopic skills using a virtual reality low cost simulator in laparoscopic surgery. The authors have considered six basic and five advanced skills. The training exercises are related to the acquisition of tasks which allow students to reach basic gestures competences. In the second phase the students will perform complex drills to acquire a correct gesture. The authors have developed a standardized, graduated and evidence-based training course. A software able to handle the training task has been created through a virtual interface based on the concept “student - exercise – evaluation”. The results are expected because data analysis will be possible only after a period of simulator testing on different samples of students. Referring to the experience reported by other authors, they expect significant results in terms of: reduction of learning time, better dexterity, ability to recognize and correct procedural errors, positive economic impact in term of better patients outcome, analyzed by codified clinical indicators.