Background: Video games have become extensively integrated into popular culture. Anecdotal observations of young surgeons suggest that video game play contributes to performance excellence in laparoscopic surgery. Training benefits for surgeons who play video games should be quantifiable. Hypothesis: There is a potential link between video game play and laparoscopic surgical skill and suturing. Design: Cross-sectional analysis of the performance of surgical residents and attending physicians participating in the Rosser Top Gun Laparoscopic Skills and Suturing Program (Top Gun). Three different video game exercises were performed, and surveys were completed to assess past experience with video games and current level of play, and each subject's level of surgical training, number of laparoscopic cases performed, and number of years in medical practice. Setting: Academic medical center and surgical training program. Participants: Thirty-three residents and attending physicians participating in Top Gun from May 10 to August 24, 2002. Main Outcome Measures: The primary outcome measures were compared between participants' laparoscopic skills and suturing capability, video game scores, and video game experience. Results: Past video game play in excess of 3 h/wk correlated with 37% fewer errors (P < .02) and 27% faster completion (P < .03). Overall Top Gun score (time and errors) was 33% better (P < .005) for video game players and 42% better (P <. 0 1) if they played more than 3 h/wk. Current video game players made 32% fewer errors (P = .04), performed 24% faster (P < .04), and scored 26% better overall (time and errors) (P < .005) than their non-playing colleagues. When comparing demonstrated video gaming skills, those in the top tertile made 47% fewer errors, performed 39% faster, and scored 41% better (P < .001 for all) on the overall Top Gun score. Regression analysis also indicated that video game skill and past video game experience are significant predictors of demonstrated laparoscopic skills. Conclusions: Video game skill correlates with laparoscopic surgical skills. Training curricula that include video games may help thin the technical interface between surgeons and screen-mediated applications, such as laparoscopic surgery. Video games may be a practical teaching tool to help train surgeons. Read more...

Background and Purpose: Performance of laparoscopic surgery requires adequate hand-eye coordination. Video games are an effective way to judge one's hand-eye coordination, and practicing these games may improve one's skills. Our goal was to see if there is a correlation between skill in video games and skill in laparoscopy. Also, we hoped to demonstrate that practicing video games can improve one's laparoscopic skills. Subjects and Methods: Eleven medical students (nine male, two female) volunteered to participate. On day 1, each student played three commercially available video games (Top Spin, XSN Sports; Project Gotham Racing 2, Bizarre Creations; and Amped 2, XSN Sports) for 30 minutes on an X-box (Microsoft, Seattle, WA) and was judged both objectively and subjectively. Next, the students performed four laparoscopic tasks (object transfer, tracing a figure-of-eight, suture placement, and knot-tying) in a swine model and were assessed for time to complete the task, number of errors committed, and hand-eye coordination. The students were then randomized to control (group A) or "training" (i.e., video game practicing; group B) arms. Two weeks later, all students repeated the laparoscopic skills laboratory and were reassessed. Results: Spearman correlation coefficients demonstrated a significant relation between many of the parameters, particularly time to complete each task and hand-eye coordination at the different games. There was a weaker association between video game performance and both laparoscopic errors committed and hand-eye coordination. Group B subjects did not improve significantly over those in group A in any measure (P >0.05 for all). Conclusion: Video game aptitude appears to predict the level of laparoscopic skill in the novice surgeon. In this study, practicing video games did not improve one's laparoscopic skill significantly, but a larger study with more practice time could prove games to be helpful. Read more...

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Objectives: To investigate whether coupling foot center of pressure (COP)-controlled video games to standing balance exercises will improve dynamic balance control and to determine whether the motivational and challenging aspects of the video games would increase a subject's desire to perform the exercises and complete the rehabilitation process. Design: Case study, pre- and postexercise. Setting: University hospital outpatient clinic. Participants: A young adult with excised cerebellar tumor, 1 middle-aged adult with single right cerebrovascular accident, and I middle-aged adult with traumatic brain injury. Intervention: A COP-controlled, video game-based exercise system. Main Outcome Measures: The following were calculated during 12 different tasks: the number of falls, range of COP excursion, and COP path length. Results: Postexercise, subjects exhibited a lower fall count, decreased COP excursion limits for some tasks, increased practice volume, and increased attention span during training. Conclusions: The COP-controlled video game-based exercise regime motivated subjects to increase their practice volume and attention span during training. This in turn improved subjects' dynamic balance control. Read more...