What if I'm just not naturally good at laparoscopy?

If you’ve ever held laparoscopic instruments and thought, “I’ll never get this,” you’re not alone. Many residents worry that surgical skill is something you’re born with, and if you’re not naturally gifted, you’ll always lag behind. The good news? That’s a myth. Laparoscopy, like any complex motor skill, is learned, practiced, and mastered, and your brain is the real MVP.

 

Why your brain needs the reps

Picture this: you’re holding the laparoscopic instruments for the first time. The angles feel off, your hands don’t quite do what you want, and depth perception seems like a bad joke. It’s frustrating, maybe even demoralizing. Fast forward a few weeks: you pick up the instruments again, and suddenly, your movements feel smoother, more coordinated. What changed?

It’s not your muscles that magically remembered; they don’t. It’s your brain. What you’re experiencing is the result of repeated practice reshaping your neural circuits, gradually allowing your hands to follow your intent almost automatically.

 

The myth of muscle memory

“Muscle memory” is a convenient phrase, but it’s misleading. What actually happens is that your brain is rewiring itself. Every time you repeat a maneuver, whether it’s knot-tying, suturing, or navigating the camera, the neural pathways that control those movements strengthen.

At first, performing laparoscopic tasks feels like solving a puzzle with your hands and eyes. Over time, the puzzle becomes second nature. Your brain has learned the patterns, leaving your hands free to execute without conscious thought. Instead of thinking in terms of “muscle memory,” think of it as neural training: your brain is learning to lead, so your hands can follow efficiently.

 

Why repetition matters more than talent

Here’s the part that will relieve a lot of anxiety: natural talent is far less important than consistent practice. Residents often ask, “What if I’m just not naturally good at laparoscopy?” The answer is simple: you can be skilled without being “naturally” gifted, as long as you practice deliberately and consistently.

Evidence backs this up. One trial showed that residents who regularly practiced laparoscopic suturing performed faster and made fewer errors than peers with less exposure (Manabe et al., 2023). Another study confirmed that repeated deliberate practice improves FLS scores (Escobar-Castijellos et al., 2020).

As one senior surgeon put it: "Surgery is just a routine and building up a routine that sticks with you."

What this means is that your starting point doesn’t define your trajectory. Even if your first attempts are awkward, every session strengthens your skills. Talent may give some people a small initial advantage, but repetition and structured practice are the true predictors of surgical competence.

 

What happens in your brain when you practice

Neuroscience backs this up. Researchers have found that repetitive surgical practice changes the brain’s motor circuits, essentially “locking in” efficient movement patterns (Kamat et al., 2022). More recent work shows that laparoscopic training even strengthens connections in areas of the brain responsible for vision-guided movement (Omurtag et al., 2025).

In plain terms: every box trainer session, simulator drill, or practice knot is not just building manual dexterity, it’s remodeling your brain for the operating room. The more structured and intentional your practice, the faster these changes happen. This explains why seemingly clumsy residents can, with dedication, reach levels of skill comparable to naturally adept peers.

 

How residents can make practice stick

If repetition is the engine, strategy is the fuel. Not all practice is equally effective—deliberate, structured, and reflective methods allow your brain to rewire faster and more efficiently. Here’s how to level up beyond basic drills:

1. Break skills into micro-components

Instead of attempting a full suturing sequence all at once, isolate sub-tasks: needle positioning, wrist rotation, knot tension, camera alignment. Master each component before reintegrating them. This segmental practice accelerates learning and reduces errors.

2. Practice under varied conditions

Vary the angle of the camera, the instruments, or the simulated tissue behavior. Controlled variation prevents skills from being context-specific and prepares you for the unpredictability of real surgery.

3. Use mental rehearsal

Even without instruments, your brain can train your hands. Studies in surgery and sports show that visualizing a procedure step-by-step strengthens neural pathways almost as much as physical repetition. Imagine resistance, tension, and depth cues as vividly as possible. Pairing mental rehearsal with physical practice compounds learning.

4. Engage in reflective practice

After each session, review what went well and what didn’t. Ask: Which movements were inefficient? Where did errors cluster? Did my camera handling lag? Reflection closes the loop between action and learning, helping you target practice more intelligently.

5. Incorporate feedback strategically

Feedback is only useful if it’s timely and specific. Use peer observation, attending input, or simulator metrics to identify key deficits. Focus on correcting one or two errors at a time, rather than overwhelming yourself with too much criticism.

6. Layer skills gradually

Master one skill before adding another. For instance, once knot-tying is fluid, integrate needle placement and camera navigation. This progressive layering mirrors how your brain consolidates complex sequences, reducing cognitive overload.

7. Track and analyze progress

Maintain a log of practice sessions: duration, drills performed, errors, and perceived difficulty. Tracking progress transforms practice from vague repetition into a structured, goal-oriented process and highlights areas needing targeted attention.

 

Bottom line

Being “naturally good” at laparoscopy is largely a myth. What matters is consistent, deliberate, and intelligent practice that engages your brain and strengthens the neural circuits controlling your hands. Every session, no matter how small, invests in future confidence when it counts: standing at the OR table with your attending watching.

So, if you’ve ever doubted yourself, here’s the takeaway: your brain is your most important surgical instrument, and it can be trained. Pick up the instruments, run the drills, and trust the process. Your hands will get smoother, your efficiency will improve, and your patients will benefit from every thoughtful repetition.