Background: Effective camera handling is fundamental to laparoscopic surgery, yet structured training in camera angulation is often underemphasized in early Minimal Invasive Surgery (MIS) education. This randomized controlled study evaluated the impact of angle-specific simulation training on novice performance across three clinically relevant trocar entry points. Methods: Twenty medical trainees with no prior MIS experience were randomized to a simulation-trained group or a theory-only control group. The study group completed fifteen structured sessions (five per angle), while controls received only a baseline lecture. All participants performed standardized bean-transfer tasks under Umbilical, Palmer’s Point, and Lee-Huang angles. Outcomes included task completion time, error patterns, and camera stability; subjective ratings assessed visualization and spatial orientation. Semi-structured interviews explored cognitive adaptation. Results: Sixteen participants completed the study. The simulation group achieved significantly faster task times across all five sessions compared with controls (all p < 0.001). Mixed-ANOVA confirmed strong between-subject (FBSE = 81.632, p < 0.001), within-subject (FWSE = 55.851, p < 0.001), and interaction effects (FIE = 8.528, p < 0.001), indicating robust training-related improvement. Angle-specific analysis demonstrated significant improvements across all camera positions, with the greatest efficiency observed at the umbilical angle and the highest difficulty at Palmer’s Point. Subjective ratings favored the umbilical angle in instrument control (p = 0.017), spatial orientation (p = 0.038), coordination (p = 0.011), and overall task ease (p = 0.001). Qualitative analysis identified three themes: initial cognitive strain at off-axis views, progressive visuospatial adaptation with repetition, and distinct angle-specific learning curves. Conclusion: Structured camera-angle simulation training significantly enhances speed, accuracy, and stability in laparoscopic visualization tasks, while improving novices’ spatial orientation and confidence. Early integration of angle-specific modules into MIS curricula may accelerate visuospatial readiness and improve foundational operative skills.
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