Validating the controls of a laparoscopic simulator for the Nintendo Wii : Can a specially designed video game be used to train basic laparoscopic skills?

Virtual reality laparoscopic simulators have been around for more than ten years and have proven to be cost- and time-effective in laparoscopic skills training. However, most simulators are considered “boring” by residents and are often poorly accessible. Consequently, these devices are rarely used in actual training. In an effort to make a low cost and more attractive simulator, a custom-made Nintendo Wii game was developed. Ultimately, this game could be used to train the same basic skills as virtual reality laparoscopic simulators ought to do. But before such a video game can be implemented into a surgical training program, it has to be validated according to international standards. The main goal of this study was to test the so-called construct and concurrent validity of the controls of a prototype of the game, which is called Wii Laparoscopy for now. In this study, the basic laparoscopic skills of experts (surgeons, urologists and gynecologists, n=15) were compared to those of complete novices (internists, n=15), using the Wii Laparoscopy (construct validity). Scores were also compared to those of the FLS Peg Transfer test, an already established assessment method for measuring basic laparoscopic skills in the United States (concurrent validity). Results showed that experts were 111% faster (p = 0.001) on the Wii Laparoscopy task than novices. Also, scores of the FLS Peg Transfer test and the Wii Laparoscopy showed a significant, high correlation (r = 0.812, p < 0.001). Although, these results mean that the current setup possesses solid construct and concurrent validity, the final version of the Wii Laparoscopy has to undergo a similar validation process, before it can be utilised in basic laparoscopic skills training.