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Another disadvantage of box training is the current lack of veterinary higher fidelity synthetic models for practicing surgical procedures. Physical models for cholecystectomy, appendectomy, and so on are commercially available, but they are all fairly expensive and most are based on human anatomy and physiology. A physical model, which can often be used only once, may not be feasible for most residency training programs if the cost is more than $100/each. Hopefully, cost‐effective medium and high fidelity synthetic models for veterinary MIS training will become more available in the future.

Highly realistic VR simulation (ssss1) is commercially available for both basic skills as well as entire simulated surgical procedures. In fact, one of the main advantages with VR training is realistic simulation of surgical procedures, which is hard to achieve to a reasonable cost in box training. For veterinarians, this advantage is somewhat limited, though, because anatomy and surgical procedures are all based on human anatomy.