Journal of Surgical Simulation 2019; 6: 5 - 10

Published: 12 April 2019


Original article

The effect of a video game warm-up on laparoscopic proficiency in a simulated setting: a randomized trial

James M.S. Andrews and Peter Hewett
Corresponding author: James M.S. Andrews, University of Glasgow School of Medicine, Glasgow, UK. Email:


Background: The concept of warming up is well established in many complex motor skills, but has only recently been of interest to those performing surgery. An increasing body of evidence suggests that there may be a measurable benefit to warming up. However, the most efficient and cost-effective method of warm-up has  yet to be established. This pilot study aims to determine if a simple video game may be used.

Methods: Medical students and junior doctors with little laparoscopic experience were recruited and randomized to either the control group (n = 10) or the intervention group (n = 10). The control group performed three increasingly complex simulated laparoscopic tasks and the time and number of errors were recorded. The intervention group spent 10 min warming up on a Playstation 3 Move video games console before performing the same simulated tasks.

Results: The performance of both groups was similar for the first two tasks. However, on the third and most complex task, the intervention group made significantly more errors than the control group.

Conclusions: Although the Playstation 3 Move video game appears to replicate laparoscopic simulation well, it does not appear to offer any benefit in performing warm-up. The results of this study suggest that warming up may be more complex than previously understood.


simulation; minimally invasive surgery; video games