Objective Laparoscopic technology is more and more widely used in liver surgery in recent years, due to the high skill requirements of laparoscopic liver surgery, a long learning curve may be needed to become technically proficient at laparoscopic liver resections.

Methods The study included liver surgeons who had over three years of working experience at the Department of Liver Surgery and Transplantation, Zhongshan Hospital, Fudan University. We aimed to evaluate the effect of simulator training on the improvement of psychomotor skills relevant to the performance of laparoscopic liver surgery. Data from patients who underwent laparoscopic left lateral sectionectomy (LLLS) by surgeons were collected and retrospectively reviewed.

Results After specific self-taught training for 120 hours, the time needed to complete suturing and knotting procedure was significantly decreased (surgeon A:141.5±17.6 s vs342.5±24.7 s; surgeon B:127.5±3.5 s vs319.5±43 s:surgeon C:132.5±3.5 s vs310±14.1 s). A total of 93 cases of LLLS were completed by the three surgeons from March 2016 to September 2018. Blood loss during the operation was 61±42 mL, without conversion case. Postoperative complication rate was 23.6% according to the Clavien-Dindo grading system, no patient died during perioperative period. The median operative time (OT) was 98 min, and 10, 8, and 23 cases were needed for the three surgeons to reach median OT, respectively.

Conclusions Laparoscopic training based on laparoscopic stimulator effectively improved the skills of laparoscopic liver surgeons, and shortened the learning curve in LLLS.