Virtual reality simulation training in laparoscopic suturing and knot-tying: a narrative review

Background and Objective: The evolving domain of surgical training, particularly in laparoscopic suturing, relies on technological advancements. This review explores the complex landscape of virtual reality (VR) simulators, focusing on their role in laparoscopic suturing training. The primary objective is to assess challenges and advancements within laparoscopic suturing methodologies, emphasizing the need for evidence-based approaches in VR surgical education. Methods: A comprehensive literature search on 5 independent databases provided studies and reviews from the last decade. Recent advancements in laparoscopic suturing training were a key focus, with specific attention to haptic feedback challenges in VR simulations, technology integration in education, and evidence-based curriculum for skills development. The review aimed to offer a comprehensive overview of challenges, advancements and gaps in VR laparoscopic suturing training. Key Content and Findings: VR simulation training emerges as pivotal for laparoscopic suturing skill development. While box trainers have limitations, VR provides immersive experiences, enhancing psychomotor abilities. The importance of trainee involvement, early exposure, and customized training durations is emphasized for effective skill development. This review explores heterogeneity in VR educational tools for laparoscopic suturing, emphasizing the significance of haptic feedback. Some studies show conflicting evidence on the effectiveness of haptic-enhanced VR, demanding further research and cost-benefit analyses. Examples provided highlight the need for evidence-based curriculum in laparoscopic suturing training. Conclusions: Laparoscopic suturing skills demand innovative training tools. VR simulators prove transformative in simplifying complex information and engaging trainees effectively. While promising, achieving VR's full potential requires ongoing efforts to refine haptic feedback realism, develop evidence- based curriculum, and comprehensively evaluate effectiveness. The review calls for wider delivery of relevant VR training programs. Ultimately, the goal is safer, more proficient, and patient-friendly minimally invasive surgical procedures through advanced training methodologies.