The virtual reality laparoscopy simulator program (LapSim Gyn v 3.0.1; Surgical Science, Gothenburg, Sweden) was run on an IBM T42 computer in a docking station (Pentium M 1.8 GHz/512 MB RAM; IBM, Armonk, NY, USA) using an interface with a diathermy pedal (Virtual Laparoscopic Interface; Immersion, San Jose, CA, USA). The operations took place in the operating theatres of the participating departments and were recorded on DVD using a camera attached to the laparoscope for later blinded evaluation. During the operation one of the authors (CRL or designated TD) observed the procedure to record the handling of the surgical instruments, any involvement of the supervisor, whether the standard procedure for the operation was followed, and whether the recording was done correctly, finalised, and assessed.