A variety of surgical simulators are available to assist surgeons in learning and practicing the technical skills needed for conducting laparoscopic surgery. Some are low-fidelity and others are high-fidelity systems that have been validated as effective surgical training systems for novice users. Proficiency and safety are unequivocally improved in the subsequent surgical performances of users.

Teaching and learning the basic technical skills required for performing laparoscopic procedures by surgical trainees has been greatly facilitated with today's surgical simulators. Published evaluation data on learning outcomes from the use of surgical simulators clearly indicate their value in surgical education. Simulators can be characterized by their fidelity to authentic surgical environments:

• Box trainers using physical objects (such as cotton string, pegs, latex tubes, and rings, some with haptics)

• Computer-based with either physical objects or virtual images of tubes, bands, balls, and so on, and instruments projected onto monitors/displays

• Virtual three-dimensional (3D) models of simulated and real tissues and organs

Some devices provide authentic surgical instruments for manipulating real objects, and others have interfaces that provide touch sensations (haptics) for virtual objects; both afford practice of the basic skills, gestures, and instrument—tissue manipulations.