1. Activate your computer. Program BESTA.guru works online on the activated
computer only. The computer is activated at the factory. If you reinstall the operating
system, the activation will be terminated.
2. User registration is possible on an activated computer only. The number of users is
unlimited. The user must enter a login in Latin letters, and this is the only restriction.
By default, the user is allocated to the training center to which the device is assigned.
3. Editing of the user is possible online, please log in to his account, where one can edit
all personal data and settings. Statistics of the tasks is available in the user’s account.
Please notice that your personal statistics is visible for the instructor of the center and
the administrator of the BESTA.guru.
4. Statistics Overview. User can view an overview (statistics) of the tasks fulfilment.
Each of the tasks is presented by the number of trials, attempts to perform tasks (Trials),
the number of tasks brought to the end (Done), the number of tasks performed with the
achievement of proficiency level (Proficient). Also the table shows the scores of the last
approach (Last), the average score of the last three trials (Last-3), the best result
demonstrated by the user (Your Best), the average result for his group (Your group) and
the best demonstrated result in the group (Best in group).
5. Statistics of each task appears on its page – at the tab "Result and Statistics". For
each of the task trials, various objective parameters are presented: the result in points,
the time shown, ambidexterity (the ratio between the right and left hands in
percentage), the path length in mm of the right and left hands, the average speed of
movement in mm/sec of the right and left tools, the maximum speed of movement in
mm/sec of the right and left tools. By default, the graph shows the following curves:
points achieved, duration and ambidexterity. User can mark and unmark parameters to
display their curves on the chart. The dashed lines on the chart indicate the average
values of the corresponding parameters demonstrated by the users of your group. User
can select the average of the entire center, whole country or the world.
All exercises fall into four different categories: Basic skills; Visualization; Clinical skills;
Suture, ligation.
1. Base skills. The category contains several tasks aimed at practicing basic, basic
skills, such as coordination, visual and spatial perception, fulcrum effect compensation
(lever effect, rotation around the fulcrum), etc.
2. Visualization. The category contains several tasks aimed at mastering the skills of
the laparoscope, its confident movement, visualization of objects hidden from direct
view, navigation by the laparoscope, coordination of combined movements of the
laparoscope and the instrument
3. Clinical skills. The category contains several tasks aimed at practicing clinical skills.
In particular, this includes the exercise of "Clipping and intersection" to simulate
mechanical ligating anatomical structures using the latest technology, and gentle
treatment of fabrics.
4. Endoscopic suture. The skills required to perform an endoscopic suture are being
practiced. The category includes a number of exercises to practice and test the needle
holder, correct and confident positioning of the needle in the branches, the formation of
the Reder node and the imposition of a loop on the structure, extracorporeal and
intracorporeal suturing.
The program of the BESTA (Basic endosurgical simulation training and certification)
was created by a Working group organized in April 2015 by the initiative of the all-
Russian public organization "Russian society for simulation education in medicine"
ROSOMED. The program contains 15 tasks dedicated to the training of the necessary
basic endosurgical skills. All together they form an effective training and certification
course. 10 tasks out of 15 serve not only for the training, but for the objective
assessment of the acquired skills (certification) also.
FLS program (Fundamentals of Laparoscopic Surgery) is one of the first and no doubt
the most deeply researched program of simulation training of the laparoscopy skills. Its
tasks have been extensively validated – there were conducted over 1.5 thousand studies
around the world. Currently, FLS is recognized in many countries of America, Europe
and Asia, it is a mandatory component of the surgical training in several countries.
Since 2010, FLS is included into the list of mandatory programs for residents of surgery
in Canada and the United States and is as a mandatory initial course of training and
evaluation of resident surgeons SAGES (Society of American Gastrointestinal and
Endoscopic Surgeons-Society of American gastrointestinal and endoscopic surgeons). To
date, about 100 FLS testing Centers are accredited in North America, and there are such
centers in Israel, France, Singapore and Saudi Arabia.
The practical part of the course FLS (Fundamentals of Laparoscopic Surgery) consists of
5 tasks, which are also listed on the site BESTA.guru
The task “Endoloop” is a part of FLS Course (Fundamentals of Laparoscopic Surgery). 
The task "Extracorporeal Suture". Three single throws of a knot are tied extracorporeally. Using a knot pusher trainee secures each throw onto the drain. 
A 12 cm long suture is passed through two markings on a Penrose drain, and three throws are tied in an intracorporeal fashion. Errors: inaccuracy of needle cuts, improper tying technique, knot insecurity, model avulsion.
The task Needle Driving (Needle Guidance) is dedicated for the training of ambidexterity, needle-holder manipulation, proper needle positioning in the jaws of needle-holder and visual-spatial coordination.
A 15 cm long suture is passed through six markings on a Penrose drain, and three throws are tied in an intracorporeal fashion forming purse string suture. Errors: inaccuracy of needle cuts, improper tying technique, knot insecurity, model avulsion.