I did not train on a professional training box. I recently trained on a home made basic training box. It was useful for me. But I want to learn about professional training box. Is it worth to pay ? Especially for advanced laparoscopic skills.

Yes I feel it is very useful to learn skills such as spatial awareness, hand-eye coordination, knot tying and intracorporeal suturing.  

I spent a lot of time on a professional and then on a home made training box. Personally I 'm convinced that after 20-30 session of 1 hour each , performing a standardised exercises sequence the lap box become totally useless. So, play a lot and when you can manage knots and suture , please move to the patient under strict and active tutoring. I don't think that a big expense could guarantee a good surgeon!

It is very useful especially for training in gas less or Lift laparoscopic surgeries

Even though I did not train myself on Lap Box but i insist and train each and every trainee of mine on Lap box.It is just not only for H-E coordination ,it is absolute  necessity to learn suturing and knotting skills with out which one cannot go to advanced Lap surgery.

I found it very useful especially for practicing intracorporal suturing.

I think Box-Training has no role in advanced laparoscopic training. Indeed, it has a certain importance in basic laparoscopic training. For advanced training Virtual Reality trainers (e.g. Simbionix, SurgicalScience) are suitable.

practice over a Box-Trainer can be done in the office or at home and it is cost effective.

I fully agree with previous comments. Box trainer very useful for basic coordination skills and especially intracorporeal suturing. Procedural skills however are still best taught in the OR on patients under active proctoring. To me virtual simulation on this moment does not provide a decent alternative to learn these procedural skills. 

I believe a box is advantageous for learning the basic skills.

It is a definite tool for basic laparoscopic training, more so if the training box comes with software to measure the performance of user. Naturally a laparoscopic simulator trainer or a 3D simulator trainer supersede the usual laparoscopic training box.

I don't believe that laparoscopic training box is a useful for training on advanced laparoscopic surgery. Instead of it, laparoscopic simulators equipped with the proper software have been proved to be beneficial educational instrument  in the first steps of educational process of advanced laparoscopic surgery.

I think it is very useful for basic laparoscopic training. If laparoscopic simulators are available, they would be a better option for advanced techniques. 

Definitely it is an important training tool for laparoscopic when combined with sound anatomical knowledge

In the very beginning of laparoscopic training it may b useful. Next step should be a laparoscopic simulator in advanced training units.

The laparoscopic training box is a tool to exercise the first steps in laparoscopic surgery. It's not expensiv and easily to do if you have 15-20 minutes free time. For advanced steps, it's beter to follow courses in the animal lab or with the more expensiv tools, like the laparoscopic simulators. After the basics, the best thing for the trainee is to do laparoscopic surgery with an experienced laparoscopic surgeon at his/her side.

The laparoscopic training box is a very usefull training instrument, especially to train eye hand coordination and getting used to the laparoscopic instruments. This tool can substantially shorten the learning curve in residents. New developments, i.e. games with laparoscopic instruments combined with Wii software will probably change dull practicing in minutes to fun gaming for hours.

The training box is useful only for the first steps in laparoscopic surgery regarding orientation and coordination of movements between the cameraman and the surgeon. Next step should be a laparoscopic simulator which is far better than the box. Anyway, everyone who want to become a laparoscopic surgeon should attend one or two courses in the animal lab before starting laparoscopic surgery. Then the first operations should be performed with an experienced surgeon on his side.

Very good question. Training box was designed to train basic skills not the advanced skills. If you want to advance lap skills attend animal lab and then ask your attending to let you do some steps of his/her advanced cases. That's the best way to learn. Then of course you get him/her to correct you during the procedure. 

I agree with the last two answers, however it is important to define whether laparoscopic suturing is considered an advanced laparoscopic exercise, I think yes it is ... maybe extracorporeal knots can leave them out of this level, but intracorporeal knots are considered many years ago as exercises advanced level (see: http://www.ncbi.nlm.nih.gov/pubmed/21319081) and even in some programs reflect this (http://sls.org/project/ TopGun /). I am responsible for a training center in my country and we use these box training for both levels (optimal for this level like colleagues say in their comments) and the advanced, but in the latter we focus on exercises intracorporeal sutures and performing anastomosis exercises.

However if you have available a laparoscopic tower and do not want to spend money on a training box, I let you the idea of a model used since 2005 by us, is a model used by urologists for exercise, but we adapted to perform exercises suture, even in 2008 won a prize with the video at a congress in my country and used also in the Pre-Congress of Guatemala Alace in 2008, we currently use in our courses and its publication (article) is currently under review.

PD: The animal model is best before performing surgery on a patient

If you want to see I leave some links and a one picture

Regards from Venezuela

https://www.facebook.com/pages/UCIM/44397726808?sk=photos_stream&tab=photos_albums

http://youtu.be/K1dnfvgbNiE

Our fellas, collagues residents said about the training box what is a silly tech to be more competent on the way to perform laparoscopic advanced surgery. they did not attend in regular basis to the classes where training box has been worked. it may be realible for the first year resident to recognise what is laparoscpy and related instruments. however simulation has been welcomed for lots of residents and colleauges WHO wish to make atraining. it is because the console for any simülatör for laparoscopy represent something like playstation or whatever. I think it should be important for a surgeon to play the game like playstation or similar games for PC to demonstrate his/her dexterity.

by the way I dont beleive it works out for a surgeon who is not willing to do so.

 I think  the learning curve of laparoscopic basic skills such as intracorporal suturing can be improved by useing laparoscopic training box. but my question is that now is there specialized laparoscopic training box such as for laparoscopic gynecological operation? and is  the invention of this specialized training box meaning and realistic?

I think it is not. I think the training box for specialized subjects such as right colectomy, surrenalectomy or gynecologic operations like promontofixation could not be builed or assembled. I beleive the virtual simulator make any surgeon WHO wish to be a competent on any subject fulfiled his/her wishes. again I think a training box under this circumstances, can take place in some congress for a kind of activity.

many years ago I did pass the FLS (Fundementals of Laparoscopic Surgery) what was a kind of exam consisting two parts done by SAGES. It was good at that time. Nowadays some software which are easy to reach and purchase give courage to be used in some clinics where advanced laparoscopic surgery has still been done by most of authors. On the other hand I dont deny the need to use a training box for the beginners in the era for lap surgery 

Good question

Laparoscopic box model training appears to improve technical skills compared with no training in trainees with no previous laparoscopic experience. The impacts of this decreased time on patients and healthcare funders in terms of improved outcomes or decreased costs are unknown. There appears to be no significant differences in the improvement of technical skills between different methods of box model training. 

There is absolutely no doubt that 'box-trainers' improve almost all measurable metrics and comparable to VR trainers. These skills are also transferrable to the OR and should be part of all surgical curriculae. http://www.laprotrain.com/

Any how, it`s neccesary for preliminary notion of what is laparoscopic technical demands and the limit of surgeon to decide whether to apply it in some proposed technical surgery or stick to open surgery.

There is no doubt that laparoscopic box training introduces and improves skills. Doing a 3 day course in a specialised centre is fine but the skills are lost within a few weeks. Better to do 2 short small courses. Better still to have a cheap box trainer that the trainee can bring home and play "skiils' with it on a regular basis. We have such a trainer tested by interns who competed with each other in completing validated skills . Such a box can be produced for less than 300 euro. We intend to introduce medical students to laparoscopic skills as part of their surgical training. The students enjoy doing it as fun, the best way to learn.