Thirty-six third-year medical students without previous surgical skills were randomised into two groups: group A students were taught basic laparoscopy skills using a conventional video-laparoscopy pelvic trainer and group B students were taught similar techniques using a cardboard box with a cut-out top to allow light and visualisation. Participants in group B had one eye obscured to reduce their stereoscopic vision. After eight sessions of training amounting to 24h, the two groups were assessed by a blinded adjudicator on set tasks using both the video-laparoscopy pelvic trainer and the cardboard box. Accuracy, timing and depth perception were assessed and the results compared.

There was no significant difference in performance scores or times between the two groups in any of the parameters when tested on the cardboard box. However, when assessed on the video trainer, the cardboard box-trained group had significantly faster times with equivalent scores in the majority of tasks.

For basic laparoscopic training the cardboard box, costing nothing, is a simple and effective alternative, which can be used in conjunction with sophisticated video-laparoscopy equipment costing thousands of dollars.

Srinath K. Chandrasekera, John F. Donohue, David Orley, Neil J. Barber, Nimish Shah, Peter M. Bishai, Gordon H. Muir

Department of Urology, King's College Hospital, London, United Kingdom

Accepted 31 May 2006 published online 15 June 2006.