Journal of Surgical Simulation 2024; 11: 11 - 24

Published: 19 April 2024


Review article

The use of augmented reality in laparoscopic surgical training: an overview

Courtney Ludick, David Rawaf, Ahmet Omurtag, Ben Simpson, Ahmed Swealem and Ali Waleed Khalid
Corresponding author: Courtney Ludick, 14 Warton Street, St Helens, WA9 5AA, UK. Email:


Introduction: Laparoscopic surgery, a minimally invasive and intricate procedure, offers substantial risk reduction and numerous patient advantages. The increasing demand for this technique has forced the derivation of efficient training methods to cultivate a competent workforce. Though various evaluation methods and programmes are available to score and teach the vast and specific set of skills required, the predominant apprenticeship model, relying on patient interaction, results in a prolonged learning curve. Alternative training modalities, including human cadavers, box trainers, virtual reality (VR) simulators and augmented reality (AR) simulators, each possess distinct benefits and limitations. AR, a cutting-edge addition to laparoscopic surgical training, combines digital images and physical models, offering a unique blend of visual realism and haptic feedback. This study aims to provide an overview of laparoscopic training modalities and assess how augmented reality compares.

Methodology: Reviewing 31 papers from diverse databases, findings were compiled and discussed.

Results: Evaluation of current market simulators revealed variations in price, modules, assessment metrics and feedback method. ProMIS AR, validated for accurately assessing laparoscopic skills, exhibits subjective limitations. Comparatively, AR demonstrates faster skill acquisition and widespread preference.

Discussion: While insufficient information hinders a decisive conclusion, AR simulation holds potential as the new gold standard for laparoscopic surgical training. Further research, encompassing a variety of simulators and modules, along with assessing mental and/or physical workload, will enhance understanding. AR’s evolution and the increased literature exploring its capabilities promise to redefine laparoscopic surgical training, pending technological advancements for heightened clinical realism.


augmented reality; surgical simulation; laparoscopic surgical training; minimally invasive surgery