Impact of Gaming Skills on Laparoscopic Performance: A Single-Blinded Randomised Controlled Trial
Authors:   Department of Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia, Teoh Zhan Huai ,   Hospital Universiti Sains Malaysia, Kelantan, Malaysia, Mohamad Ikhwan Sani ,   Department of Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia,   Hospital Universiti Sains Malaysia, Kelantan, Malaysia, Mohammad Azmi Mohd Azem Fathi ,   Department of Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia,   Hospital Universiti Sains Malaysia, Kelantan, Malaysia, Soh Jien Yen ,   Department of Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia,   Hospital Universiti Sains Malaysia, Kelantan, Malaysia, Wong Michael Pak-Kai ,   Department of Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia,   Hospital Universiti Sains Malaysia, Kelantan, Malaysia, Wan Muhamad Mokhter Wan Muhammad Mokhzani ,   Department of Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia,   Hospital Universiti Sains Malaysia, Kelantan, Malaysia, Md Hashim Mohd Nizam ,   Department of Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia,   Hospital Universiti Sains Malaysia, Kelantan, Malaysia, Wan Zain Wan Zainira ,   Department of Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia,   Hospital Universiti Sains Malaysia, Kelantan, Malaysia, Syed Abd Aziz Syed Hassan ,   Department of Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia,   Hospital Universiti Sains Malaysia, Kelantan, Malaysia
Published: January 2025

Skills required in laparoscopic surgery are not the natural extend from open surgery. It has been
demonstrated that modern video gaming improves the acquisition of these skills. This study aims
to evaluate the improvement of virtual laparoscopic performance among house officers’ with
or without gaming. This single-blinded randomised controlled trial was conducted in Hospital
Universiti Sains Malaysia from September 2021 until February 2023. Participants were randomised
into control (non-gamer) and intervention (gamer) groups using a stratified block randomisation
method. Intervention groups were assigned to structure gaming session using the Nintendo
Switch in between laparoscopic simulation. Laparoscopic skills were assessed using laparoscopic
cholecystectomy simulation programme. Eleven performance metrics were recorded. Demographic
data was analysed using Student’s t-test and Fisher’s Exact Test. Laparoscopic performance results
were analysed using repeated measure ANOVA test. A total of 54 house officers were recruited, with
a median age of 26 years. Among the 13-performance metrics, the intervention group showed 5/11
metrics significantly improved compared to 3/11 in the control group. Overall performance by total
time to complete tasks was significantly improved among the intervention group (F(2,28) = 7.720,
P = 0.001). Path length for both dominant and non-dominant hands improved in the intervention
group but not statistically significant. Dexterity assessed by total mistake and total clips wasted
significantly better among intervention group (F(2,28) = 6.924, P = 0.002, F(2,28) = 4.262, P = 0.018).
The study shows modern video gaming skills improve laparoscopic performance, hinting at serious
game integration in training, potentially revolutionising clinical education. Gaming might become
a prerequisite for laparoscopic surgery trainees, enhancing motivation and engagement alongside
traditional simulators.