***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE " Dry lab " facilities are integral to laparoscopy training , but access is often limited due to the high costs of video-laparoscopy equipment . We assessed the effectiveness of a cheap and simple training model compared to conventional video-laparoscopy for basic training using a r and omised , blinded study . METHODS Thirty-six third-year medical students without previous surgical skills were r and omised 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 . RESULTS 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 . CONCLUSION 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 thous and s of dollars PURPOSE Many sophisticated and expensive trainers have been developed to assist surgeons in learning basic laparoscopic skills . We developed an inexpensive trainer and evaluated its effectiveness . MATERIAL S AND METHODS The webcam laparoscopic training device is composed of a webcam , cardboard box , desk lamp and home computer . This homemade trainer was evaluated against 2 commercially available systems , namely the video Pelvitrainer ( Karl Storz Endoscopy , Culver City , California ) and the dual mirror Simuview ( Simulab Corp. , Seattle , Washington ) . The Pelvitrainer consists of a fiberglass box , single lens optic laparoscope , fiberoptic light source , endoscopic camera and video monitor , while the Simuview trainer uses 2 offset , facing mirrors and an uncovered plastic box . A total of 42 participants without prior laparoscopic training were enrolled in the study and asked to execute 2 tasks , that is peg transfer and pattern cutting . Participants were r and omly assigned to 6 groups with each group representing a different permutation of trainers to be used . The time required for participants to complete each task was recorded and differences in performance were calculated . Paired t tests , the Wilcoxon signed rank test and ANOVA were performed to analyze the statistical difference in performance times for all conditions . RESULTS Statistical analyses of the 2 tasks showed no significant difference for the video and webcam trainers . However , the mirror trainer gave significantly higher outcome values for tasks 1 and 2 compared to the video ( p = 0.01 and < 0.01 ) and webcam ( p = 0.04 and < 0.01 , respectively ) methods . ANOVA indicated no overall difference for tasks 1 and 2 across the orderings ( p = 0.36 and 0.99 , respectively ) . However , by attempt 3 the time required to complete the skill tests decreased significantly for all 3 trainers ( each p < 0.01 ) . CONCLUSIONS Our homemade webcam system is comparable in function to the more elaborate video trainer but superior to the dual mirror trainer . For novice laparoscopists we believe that the webcam system is an inexpensive and effective laparoscopic training device . Furthermore , the webcam system also allows instant recording and review of techniques Abstract Background : Laparoscopic skill was measured objective ly through a series of seven tasks in an inanimate laparoscopic simulator . Seven analogous skills were tested in an in vivo porcine model . These skills included transferring , cutting , clipping , placement of a ligating loop , mesh placement , and suturing with an intracorporeal and extracorporeal knot . Scoring of each task rewarded precision and speed . Methods : Twelve PGY3 residents were given a baseline evaluation in the simulator and in the animal model . They were then r and omized to either five practice sessions in the simulator ( group A ) or no practice ( group B ) . Each group was retested in the simulator and in the animal ( final test ) . Scores in vivo were compared by t-test for baseline versus final evaluation for each group . Linear regression analysis was used to correlate in vivo and in vitro scores for each task and for the total score ( sum of all scores ) . Results : Group A showed significant improvement in performance in vivo for cutting , clipping , mesh placement , and suturing with an intracorporeal and extracorporeal knot , as well as in the total score ( p < 0.05 ) . Group B showed significant improvement in suturing with an intracorporeal and extracorporeal knot , and in the total score . The magnitude of improvement from baseline to final evaluation was significantly greater for group A ( p < 0.05 ) . There was significant correlation between in vitro and in vivo total scores and the score for each task ( p < 0.05 ) except for placement of the ligating loop and mesh . Conclusions : Performance in an in vitro laparoscopic simulator correlated significantly with performance in an in vivo animal model . Practice in the simulator result ed in improved performance in vivo OBJECTIVES To evaluate the utility of a portable , at-home , low-cost , camera-less laparoscopic trainer to provide laparoscopy training inexpensively and outside the constraints of the hospital environment . METHODS Twenty-two urology residents ( postgraduate year 1 to 7 ) were tested prospect ively on four basic laparoscopic tasks on a st and ard video laparoscopic trainer ( pretest ) . Objective and subjective data were collected for each participant . The subjects were then r and omized to 5 hours of training on either a portable , camera-less trainer ( group 1 ) or a st and ard video laparoscopic trainer ( group 2 ) . Each resident was then retested on the initial same four laparoscopic tasks ( post-test ) . Efficiency ratios were calculated for each task , incorporating both time and accuracy . Improvements between the pretest and post-test evaluations were compared between the two groups using the two-group t test . RESULTS All subjects significantly improved their performance with training . The average improvement in the time required to complete the laparoscopic tasks for all participants was 36 % . Efficiency increased by 52 % . However , no difference was found between the two groups . In the post study self-evaluations , 91 % of participants in group 1 either agreed or strongly agreed that the at-home trainer was a helpful teaching modality . CONCLUSIONS The improvements in laparoscopic skills on our inexpensive , portable , at-home , camera-less trainer were not significantly different from those gained using a traditional video laparoscopic trainer . Participants trained on our portable trainer were able to improve objective ly and subjectively by both external and internal evaluations . Thus , our system will allow trainees to develop their laparoscopic skills in an inexpensive manner in the comfort of their own home BACKGROUND The loss of three-dimensional visual depth cues has been thought to be the main hindrance to the acquisition of endoscopic skills . However , the " fulcrum effect " of the abdominal wall on the manipulation of instruments has not to our knowledge been previously investigated . METHODS Subjects with no experience in endoscopy were required to make multiple defined incisions under laparoscopic laboratory conditions  , within ten two-minute periods in the first study and 50 in the second . Eleven subjects operated under normal imaging conditions and 11 with the y-axis inverted .  RESULTS Subjects who operated with the image inverted made significantly more incisions and significantly more correct incisions than those working under normal conditions . This effect persisted over 50 trials . CONCLUSIONS The fulcrum effect has a major detrimental influence on acquisition of endoscopic skills . Further work is required to investigate the role of image inversion in clinical endoscopic training PURPOSE This multicenter regional trial aim ed to evaluate prospect ively whether a home-constructed training system comprised of a camcorder , st and ard television , and laparoscopic box trainer could be used to advance intracorporeal laparoscopic suturing skills . SUBJECTS AND METHODS Ten urology residents attended a 1-hour teaching session on laparoscopic suturing  at the outset of the study . Baseline times and quality assessment were recorded for single-knot intracorporeal laparoscopic sutures , performed on st and ard laparoscopic stack systems , directly after instruction . Four residents were assigned to train regularly for 4 to 8 weeks on the home-constructed system . All participants were reassessed after 4 weeks on st and ard laparoscopic stacks , and the times of the study group and controls were compared . RESULTS Baseline times were not significantly different ( p = 0.2764 ) between the study group and controls . However , the study -group times ( 111.3 + /- 6.874 [ SEM ] seconds ) were significantly better ( p < 0.0001 ) than those of the control subjects ( 202.2 + /- 16.96 seconds ) after 4 weeks and an average of 303 minutes of total training time on the home-constructed system . Furthermore , subjects training on this system were more likely to throw an acceptable knot ( 100 % ) than were the controls ( 66 % ) . Two subjects who trained for a further 4 weeks achieved greater improvement in facility . CONCLUSIONS Intracorporeal suturing skills can be learned using a home-constructed system . This could be beneficial for those wishing to develop the advanced skills required for various laparoscopic urologic procedures STUDY OBJECTIVE To describe and vali date the Pelv-Sim trainer , an innovative training model for gynecologic laparoscopic suturing with 4 laparoscopic exercises : closing an open vaginal cuff , transposing an ovary to the pelvic sidewall , ligating an infundibulopelvic ligament , and closing a port-site fascial incision . DESIGN R and omized controlled trial ( Canadian Task Force classification I ) . SETTING Academic medical center . PARTICIPANTS Obstetrics and gynecology residents ( n = 19 ) and third-year medical students ( n = 10 ) . INTERVENTIONS To test the Pelv-Sim model for construct validity , all participants were timed as they completed the 4 tasks , and their performances were compared . The residents were then r and omized to a study group asked to train with the Pelv-Sim for 1 hour/week for 10 weeks , or to a control group . To evaluate the effectiveness of training with the Pelv-Sim model , both groups of residents were retested at the end of the 10-week study period . Pretraining and posttraining performances were compared within each group . MEASUREMENTS AND MAIN RESULTS Before the intervention , the residents completed all 4 tasks in significantly less time than the medical students ( all p values < or=.012 ) . When retested after the 10-week study period , the control group showed no significant performance improvements . The trained group showed significant improvement in performance for the vaginal cuff closure task ( p = .004 ) and the ovary transposition task ( p = .047 ) , but not for the infundibulopelvic ligament ligation or the fascial closure tasks . CONCLUSION Construct validity was shown for all 4 Pelv-Sim simulation tasks . Resident training improves performance on the vaginal cuff closure and ovary transposition tasks . The Pelv-Sim has the potential to be a valuable tool in laparoscopic training for gynecology residents Abstract Background : In this paper , we explored a quick and inexpensive method to evaluate the improvement in laparoscopic skills gained by residents after attending a formal training course in laparoscopy . Methods : Surgical residents attending an endoscopic workshop  were r and omly selected to perform tasks in a training simulator . Each was evaluated qualitatively and quantitatively before and after the workshop . A  control group of six residents who did not attend the workshop  were selected to perform the same tasks twice in succession . Results : The total mean time improvement for all tasks in the study group was 34.3 % and in the control group 7.3 % ( p= 0.0001 ) . When the data was separated for each task , statistically significant improvement was demonstrated in five of the six tasks . Conclusions : Residents who attend a formal workshop in endoscopy can gain significant improvement in skills . The methods described in this study can be used to quantitatively measure this improvement throughout a resident 's training BACKGROUND Developing technical skill is essential to surgical training , but using the operating room for basic skill acquisition may be inefficient and expensive , especially for laparoscopic operations . This study determines if laparoscopic skills training using simulated tasks on a video-trainer improves the operative performance of surgery residents . STUDY DESIGN Second- and third-year residents ( n= 27 ) were prospect ively r and omized to receive  formal laparoscopic skills training  or to a control group . At baseline , residents had a vali date d global assessment of their ability to perform a laparoscopic cholecystectomy based on direct observation by three evaluators who were blinded to the residents ' r and omization status . Residents were also tested on five st and ardized video-trainer tasks . The training group practice d the video-trainer tasks as a group for 30 minutes daily for 10 days . The control group received no formal training . All residents repeated the video-trainer test and underwent a second global assessment by the same three blinded evaluators at the end of the 1-month rotation . Within-person improvement was determined ; improvement was adjusted for differences in baseline performance . RESULTS Five residents were unable to participate because of scheduling problems ; 9 residents in the training group and 13 residents in the control group completed the study . Baseline laparoscopic experience , video-trainer scores , and global assessment s were 
    Output:
    
All studies showed a significant improvement of basic laparoscopic skills after training with BMs .
Furthermore , their low costs make them easily available to most surgical trainees .