The training of novices using MIST-VR yields quantifiable changes in skill that are transferable to a simple real task and are similar to the results achieved with conventional training.

The Basic Surgical Skills course produces quantifiable improvements in laparoscopic skill that are measurable by MIST-VR. There is a learning effect associated with using MIST-VR alone.

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Three children with chronic intussusception are reported together with a review of the literature. Neither the palpation of a mass nor the passage of blood per rectum was necessary for the diagnosis. Weight loss was seen in each case and 1 child was investigated for malabsorption. In all 3 children there was a delay in diagnosis, and it is suggested that a chronic intussusception should be considered more frequently in children with persistent abdominal symptoms for which no cause can be found. Although a barium enema was helpful diagnostically, it did not result in the reduction of the intussusception. The problem of a recurrence after a reduction and its subsequent management is discussed.

Two cases of metastasis to the penis from a primary rectal carcinoma are described. The clinical features, treatment and prognosis together with the probable modes of metastasis are discussed. All previously reported cases of penile metastasis from the rectum are reviewed. It is suggested that contrary to previous reports that prognosis is not uniformly poor and hence a more aggressive attitude to treatment should be adopted. Metastatic lesions in the penis should also be considered as a cause of urinary obstruction following abdominoperineal excision of the rectum.