Background
Minimally invasive surgery (MIS) requires mastery of complex skills, for which diverse training methods have been developed. While some methods focus on precise instrument tracking and others on realistic practice scenarios, combining these aspects leads to increased costs and impractical setups.

The Leap Motion Controller (LMC) is a cost-effective device offering precise motion tracking, but previous studies found its utility in surgical training is limited by line-of-sight issues. This study aims to address this challenge.

Methods
A novel interface was developed for use of LMC for tracking MIS instruments during practice. To resolve the line-of-sight problem, the traditional enclosed working area was replaced with a single vertical barrier concealing the task while allowing the LMC to maintain a clear horizontal view of the instrument. Performance metrics included time to task completion and total path length of the instrument. Twenty-eight medical students participated, performing 40 consecutive trials each.

Results
The LMC provided precise tracking, effectively resolving line-of-sight issues. Participants improved significantly, with task completion time decreasing from 61 s (SD = 40) to 19 s (SD = 8) and path length from 2390 mm (SD = 2569) to 574 mm (SD = 348). Performance plateaued after 20 trials, with reduced variance for all outcomes.

Conclusions
The study successfully leveraged the LMC for tracking surgical instruments, overcoming previous limitations. The setup enables real-time monitoring, continuous movement tracking, and tactile interaction with physical objects. Its affordability and simplicity make it a promising tool for traditional and home-based MIS training, especially in resource-limited settings.