eoSurgical are now part of the Limbs & Things family

Evidence Base

There is a robust evidence-base for eoSim and SurgTrac. For both basic and advanced skills training. From multiple specialties and countries. Over 30 peer reviewed articles.

 Here are highlights from recent papers (full references below):

SurgTrac metrics personalise training: “We analysed the largest database of simulated laparoscopic task performances (13,027 tasks undertaken by 578 users). Performance improves with practice. Using learning curves derived from peer-group performances as benchmarks, users may be regularly and objectively assessed to support personalisation of training.” Keni et al 2020.

Take-home simulator use improves skills in gynaecology trainees: “A take‐home box trainer simulation‐training program was associated with improvement in laparoscopic skills. This type of program may improve trainee access to simulation training.” Wilson et al 2018.

SurgTrac AR metrics validity: “The eoSim laparoscopic AR simulator is regarded as a realistic, accessible, and useful tool for the training of basic laparoscopic skills, with good face validity. Construct validity of the eoSim AR simulator was demonstrated on several core variables, but not all.” Arts et al 2019.

eoSim compares favourably with robotic devices: “The learning curve of minimally invasive suturing shows a shorter task time curve using robotic assistance compared to the laparoscopic curve. However, laparoscopic outcomes show good end results with rapid outcome improvement.” Leijte et al  2019.

eoSim helps validate paediatric surgical OA and CDH models: "The two low-cost, readily available models evaluated in this study are considered valid for training and suitable for residents, fellows, starting and more experienced paediatric surgeons. The minimally invasive anastomoses of an oesophageal atresia and closure of congenital diaphragmatic hernia can be practiced using these newly developed models." Bokkerink et al 2020.

eoSim helps identify barriers and facilitators to deliberate practice with take-home simulators: “Scheduled simulation sessions which provide trainees with the opportunity for consultant feedback may improve engagement. Tackling the ‘point-scoring’ culture is more challenging. This could be addressed by modified assessment structures, greater recognition and accountability for trainers, and recognition and funding of simulation strategies including in-house skills sessions.” Blackhall et al 2019.

The use of mobile computing devices in microsurgery.  Pafitanis G, Hadjiandreou M, Miller R, Mason K, Theodorakopoulou E, Sadri A, Taylor K, Myers S. Arch Plast Surg. 2019 Mar;46(2):102-107. doi: 10.5999/aps.2018.00150. Epub 2019 Mar 31. PMID: 30934172; PMCID: PMC6446033.




Emotional visual stimuli and simulated laparoscopic surgical performance: A pilot cohort study. Andrew Keenlyside, Beatrice Rae, Paul M. Brennan, Mark A. Hughes. The Surgeon (2023). ISSN 1479-666X, https://doi.org/10.1016/j.surge.2023.06.004.

Objective assessment for open surgical suturing training by finger tracking can discriminate novices from experts. Vera Hillemans, Xander van de Mortel, Otmar Buyne, Bas H. Verhoeven & Sanne M.B.I. Botden. Medical Education Online (2023), 28:1, DOI: 10.1080/10872981.2023.2198818


The Impact of Novel Nontechnical Stressors (Visual and Auditory) on Simulated Laparoscopic Task Performance Among Surgeons and Students. Mark A. Hughes, Lewis Swan, Caitlyn L. Taylor, Razvan Ilin, Roland Partridge, and Paul M. Brennan. Journal of Laparoendoscopic & Advanced Surgical Techniques.Feb 2022.189-196.http://doi.org/10.1089/lap.2021.0695
Scotland's "Incentivised Laparoscopy Practice" programme: Engaging trainees with take-home laparoscopy simulation. Walker, K. G., Shah, A. P., Brennan, P. M., Blackhall, V. I., Nicol, L. G., Yalamarthi, S., Vella, M., & Cleland, J. The Surgeon. Advance online publication. https://doi.org/10.1016/j.surge.2022.05.007

The effect of continuous at-home training of minimally invasive surgical skills on skill retention. Joosten, M., Hillemans, V., van Capelleveen, M. et al. Surg Endosc (2022). https://doi.org/10.1007/s00464-022-09277-9


The Effect of an Interval Training on Skill Retention of High-Complex Low-Volume Minimal Invasive Pediatric Surgery Skills: A Pilot Study. Joosten M, Bökkerink GMJ, Stals JJM, Leijte E, De Blaauw I, Botden SMBI.  J Laparoendosc Adv Surg Tech A. 2021;31(7):820-828.


Using Automated Continuous Instrument Tracking to Benchmark Simulated Laparoscopic Performance and Personalize Training. Keni S, Ilin R, Partridge R, Hughes MA, Brennan PM. J Surg Educ. 2020;S1931-7204(20)30371-8. doi: 10.1016/j.jsurg.2020.09.021.

Validation of low-cost models for minimal invasive surgery training of congenital diaphragmatic hernia and esophageal atresia. Bökkerink GM, Joosten M, Leijte E, Lindeboom MY, de Blaauw I, Botden SM. J Pediatr Surg. 2020;S0022-3468(20)30413-9. doi: 10.1016/j.jpedsurg.2020.05.045

Competency assessment tool for laparoscopic suturing: development and reliability evaluation.  IJgosse WM, Leijte E, Ganni S, et al. Surg Endosc. 2020;34(7):2947-2953. doi:10.1007/s00464-019-07077-2


The use of mobile computing devices in microsurgery. Pafitanis G, Hadjiandreou M, Miller R, Mason K, Theodorakopoulou E, Sadri A, Taylor K, Myers S. Arch Plast Surg. 2019 Mar;46(2):102-107. doi: 10.5999/aps.2018.00150. Epub 2019 Mar 31. PMID: 30934172; PMCID: PMC6446033.

Face, Content, and Construct Validity of the Take-Home EoSim Augmented Reality Laparoscopy Simulator for Basic Laparoscopic Tasks. Arts EEA, Leijte E, Witteman BPL, Jakimowicz JJ, Verhoeven B, Botden SMBI. J Laparoendosc Adv Surg Tech A. 2019;29(11):1419-1426. doi:10.1089/lap.2019.0070 

Construct, content and face validity of the eoSim laparoscopic simulator on advanced suturing tasks. Leijte E, Arts E, Witteman B, Jakimowicz J, De Blaauw I, Botden S. Surg Endosc. 2019;33(11):3635-3643. doi:10.1007/s00464-018-06652-3

Take-home laparoscopic simulators to develop surgical skills: Analysing attitudes to, and barriers and enablers of, their use in gynaecology training. Wilson E, Jolly B, Beckmann M, Janssens S, Hewett D, Wilkinson S. Focus on Health Professional Education. 2019 20(3) dx.doi.org/10.11157/fohpe.v20i3.352

Construct validity of eoSim - a low-cost and portable laparoscopic simulator.
Mansoor SM, Våpenstad C, Mårvik R, Glomsaker T, Bliksøen M. Minim Invasive Ther Allied Technol. 2019;1-8. doi:10.1080/13645706.2019.1638411

Barriers and facilitators to deliberate practice using take-home laparoscopic simulatorsBlackhall VI, Cleland J, Wilson P, Moug SJ, Walker KG. Surg Endosc. 2019;33(9):2951-2959. doi:10.1007/s00464-018-6599-9

Robot assisted versus laparoscopic suturing learning curve in a simulated setting.  Leijte E, de Blaauw I, Van Workum F, Rosman C, Botden S. Surg Endosc. 2019;10.1007/s00464-019-07263-2. doi:10.1007/s00464-019-07263-2 

Does Personal Learning Style Predict the Ability to Learn Laparoscopic Surgery? A Pilot Study. Retrosi G, Morris M, McGavock J. J Laparoendosc Adv Surg Tech A. 2019;29(1):98-102. doi:10.1089/lap.2018.0196


Improved laparoscopic skills in gynaecology trainees following a simulation - training program using take home box trainers. Wilson E, Janssens S, McLindon L, Hewett D, Jolly B, Beckmann M. ANZJOG 2018 doi:10.1111/ajo.12802


A systematic review of low-cost laparoscopic simulators. Li MM, George J. Surg Endosc. 2017;31(1):38-48. doi:10.1007/s00464-016-4953-32016


Incentivising practice with take-home laparoscopic simulators in two UK Core Surgical Training programmes
Nicol LGWalker KGCleland J, Partridge RW, Moug SJ. On behalf of the Scottish Surgical Simulation Collaborative, including Royal College of Surgeons of Edinburgh, Royal College of Physicians and Surgeons of Glasgow, NHS Education for Scotland. BMJ Simulation and Technology Enhanced Learning; BMJ Simulation and Technology Enhanced Learning 2016; 2:112-117.

The LEAP Gesture Interface Device and Take-Home Laparoscopic Simulators: A Study of Construct and Concurrent Validity. Partridge RW, Brown FS, Brennan PM, Hennessey IAM, Hughes MA. Surgical Innovation 2016, Vol. 23(1) 70–77. 

Does a 3D Image Improve Laparoscopic Motor Skills? Folaranmi SE, Partridge RW, Brennan PM, Hennessey IAM. Journal of Laparoendoscopic & Advanced Surgical Techniques. August 2016, 26(8): 671-673.


Motion Analysis–Based Skills Training and Assessment in Pediatric Laparoscopy: Construct, Concurrent, and Content Validity for the eoSim Simulator. Retrosi G, Cundy T, Haddad M, Clarke S.  Journal of Laparoendoscopic & Advanced Surgical Techniques. 2015 Aug 10.

Effect of Warm-up Exercises on Laparoscopic Trainer: Improvement of Operator Smoothness. Navaneethan N, Hewett P. World J Lap Surg 2015; 8(1): 21-25. 

There is a worldwide shortfall of simulation platforms for minimally invasive surgery. Partridge RW, Hughes MA, Brennan PM, Hennessey IAM. Journal of Surgical Simulation (2015) 2, 12–17.


Accessible Laparoscopic Instrument Tracking (“InsTrac”): Construct Validity in a Take-Home Box Simulator.  Partridge RW, Hughes MA, Brennan PM, Hennessey IAM. Journal of Laparoendoscopic & Advanced Surgical Techniques. 2014 Jul 31;24(8):578–83.

A comparative study of surgical skills assessment in a physical laparoscopic simulator using wireless inertial sensors. Evans RL, Partridge RW, Arvind DK. Proceedings of the Wireless Health 2014, National Institutes of Health, ACM, NY, USA,  Article 10, pages 1-8. 

Surgical training is undermined by inadequate provision of laparoscopic surgical simulators. Brennan P, Loan JM, Hennessey IA Hughes M, Partridge RW.  Bull R Coll Surg Engl 2014 Oct 1;96(9):304–7.

The business of innovation in surgery: tenacity is the key. Brown F. Student BMJ. 2014;22:g5569

Validating the Use of Smartphone-Based Accelerometers for Performance Assessment in a Simulated Neurosurgical Task. Ang WJ, Hopkins ME, Brennan PM, Partridge R, Hennessey I, Hughes MA. Neurosurgery 2014 Mar;10:57–65.

Effect of Visual Display Location on Human Performance in Simulated Laparoscopic Tasks. Hernandez R, Travascio F, Onar-Thomas A and Asfour S. J Ergonomics 2014. 4:134.


Construct, Concurrent, and Content Validity of the eoSim Laparoscopic Simulator. Hennessey IAM, Hewett P. Journal of Laparoendoscopic & Advanced Surgical Techniques. 2013 Oct;23(10):855-60.

Incorporating touch screen technology into minimal access simulation. Hennessey IAM, Brennan P, Hughes MA, Partridge RW. J Laparoendosc Adv Surg Tech Part B: Videoscopy. Jan 2013.

Pre-operative warm up: are we missing an opportunity to improve performance? Loan JJM, Hughes MA. Int J Surg. 2013;11(5):434.

An app to make a surgeon. Ferns F. Student BMJ, 10.1136/sbmj.f3361. June 2013.


Construct, Concurrent and Content validity for the eoSim® Laparoscopic Simulator adapted for Paediatric Laparoscopic Surgery.  Giuseppe Retrosi, Thomas P Cundy, Munther J Haddad, Simon A Clarke. International Pediatric Endosurgery Group Annual Congress for Endosurgery in Children. April 14-18th 2015.

One small step for eoSim, one giant LEAP for surgery? A exploration of the application of the LEAP motion controller in simulated MIS surgery. Brown F, Partridge RW. Scottish Society of Paediatric Surgeons meeting, Edinburgh, 1st November 2014. (Winner: Best Presentation Award).

Does peer-to-peer comparison improve skills acquisition during take-home surgical simulator training? Deehan G, Struthers J, Partridge RW. AMEE, Milan, 2014.

A Gesture Interface Environment to Train and Prepare Surgeons. Hughes MA. Medicine 2.0: Social Media, Mobile Apps, and Internet/Web 2.0 in Health, Medicine and Biomedical Research. London, UK. 23rd September 2013.

Validating the Use of Smartphone-based Accelerometers for Performance Assessment in a Simulated Neurosurgical Task. Ang WJ, Hopkins ME, Brennan PM, Partridge R, Hennessey I, Hughes MA. World Federation of Neurological Surgeons Congress, South Korea, 8-13th September 2013.

How starting a company can get your clinical innovation off the ground. Hughes MA, Brennan PM, Partridge R. Norwich Medical Technology and Innovation Symposium, UEA, Norwich, 20th April 2013.