Table 2.

Summary of characteristics of excluded studies

Study	Participants (n)	Benchmark measurements	Level of expertise	VR Training Modality	VR Training Performed	Control group	Assessment method	Recorded results	Reason for exclusion
Clevin & Grantcharov (2008)41	16	Nil	Novice	LapSim® (Surgical Sciences Sweden AB)	Simulator exercises: camera navigation, instrument navigation, coordination, grasping, lifting, cutting and clip applying. Box training exercises: moving pegs, cutting, introducing an epidural catheter in an infusion tube, applying clips, cutting for 5-minute didactic hands-on instruction on simulator followed by 3 hours on a box model trainer.	No additional training	Simulator exercises	Time, misses, drift, path length, angular path	No documentation of specific mean results other than p-value
Gallacher et al (2013)42	225	Nil	Novice and expert	MIST-VR	Simulator exercises: experts and novices: holding items, instrument manipulation	No additional training	Simulator exercises - cutting, grasping, instrument manipulation, object manipulation	Correct incisions, errors	No documentation of specific mean results other than p -value
Grantcharov et al (2004)43	16	Nil	Novice	MIST-VR	6 simulator exercises	No additional training	Simulated laparoscopic cholecystectomy	Errors, economy of movement	No documentation of specific mean results other than p -value
Hiemstra et al (2011)8	50	Nil	Naïve	Simendo®	Simulator exercises	No additional training	Simulator exercises	Time, path length, motion	Evaluation of data showed comparison done between VR, box-trainer and control. data inadequate for the study
Munz et al (2004)44	24	Nil	Naïve	LapSim	Simulator exercises: instrument navigation, coordination, grasping, cutting, precision, speed for 3 weekly sessions of 30 minutes each	No additional training	Simulator exercises	Distance, time, economy of movement, errors	No documentation of specific mean results other than p -value
Pearson et al (2002)9	43	Nil	Naïve	MIST-VR	Simulator exercises: knot tying	No additional training	10 knot-tying trials	Economy of movement, errors, time	No documentation of specific mean results other than p -value
Torkington et al (2000)45	30	Nil	Naïve	MIST-VR	6 simulator tasks: minimal-access training tasks performed over a period of one hour	No additional training	Drills performed using the Imperial College Surgical Assessment Device	Distance, movements, speed, time	Data compared values for both right- and left-handed use of laparoscopic tools. No overall data was recorded. Excluded to avoid bias.
Van Bruwaene et al (2015)46	30	Nil	Novice	Lap Mentor™ (3D Systems)	Proficiency based: simulator exercises and box trainer exercises: laparoscopic cholecystectomy exercises for 5 hours	No additional training	Laparoscopic cholecystectomy on an anaesthetised pig	Time, performance score	No documentation of specific mean results other than p-value

MIST-VR, minimally invasive surgery trainer – virtual reality; VR, virtual reality