Justo-Janeiro JM, Pedroza-Meléndez A, Prado E, Theurel-Vincent G, Vázquez-de Lara LG

Language: Spanish
References: 18
Page: 19-23
PDF size: 79.41 Kb.

ABSTRACT

Background: Simulators are effective devices for the development of certain skills needed in laparoscopic surgery. Bench models with laparoscopy equipment, virtual reality and mirror boxes have been used; however, they have limitations such as the need for laparoscopy equipment, high cost or a considerable mismatch with reality.
Methods: We undertook this study to test a simulator as a training device that allows the acquisition of eye-hand coordination and two-dimensional spatial orientation without the need of laparoscopic equipment. The simulator consists of a box with an internal light and a color video CCD connected to a television set. Quality of vision, illumination and adequacy as training equipment was assessed by experienced laparoscopic surgeons. Thereafter, 12 general surgeons without experience in laparoscopic surgery and 18 surgery trainees performed seven different drills after a short course on basic skills and knot-tying laparoscopic techniques. The time to completion of each task was recorded at the beginning and after 10 practices of 30-min each.
Results: Ten experienced surgeons qualified with the simulator with a mean of 42 points (40-44 from a 44 total). There were significant reductions in the final times of all participants. Paired t-test was significant in all the measurements. The mean time decreased 31.8% (from 1108 ± 96 to 755 ± 107 sec) with a 95% confidence interval of 15.1-48.5%.
Conclusions: The simulator tested in this study helps to develop laparoscopic surgical skills economically and without the need for laparoscopic equipment. This laparoscopy training equipment is novel and original in its design.

REFERENCES

1. Munz Y, Kumar BD, Moorthy K, Bann S, Darzi A. Laparoscopic virtual reality and box trainers: is one superior to the other? Surg Endosc 2004;18:485-494.

2. Scott DJ, Young WN, Tesfay ST, Frawley WH, Rege RV, Jones DB. Laparoscopic skills training. Am J Surg 2001;182:137-142.

3. Rogers DA, Elstein AS, Bordage G. Improving continuing medical education for surgical techniques: applying the lessons learned in the first decade of minimal access surgery. Ann Surg 2001;233:159-166.

4. Scott DJ, Bergen PC, Rege RV, Laycock R, Tesfay ST, Valentine RJ, et al. Laparoscopic training on bench models: better and more cost effective than operating room experience? J Am Coll Surg 2000;191:272-283.

5. Hyltander A, Liljegren E, Rhodin PH, Lonroth H. The transfer of basic skills learned in a laparoscopic simulator to the operating room. Surg Endosc 2002;16:1324-1328.

6. Swanstrom LL, Fried GM, Hoffman KI, Soper NJ. Beta test results of a new system assessing competence in laparoscopic surgery. J Am Coll Surg 2006;202:62-69.

7. Soto GM. Simulador para el dominio de procedimientos básicos en cirugía laparoscópica. Cir Endosc 2002;3:25-27.

8. Sereno-Trabaldo S, Fregoso-Ambriz JM, Gaxiola-Robles R, Zermeño-Hernández J, García-Íniguez JA, González-Ojeda A. Measurement of the development of psychomotor abilities in surgical endoscopy training with the use of a simulator and biological pieces. Cir Ciruj 2005;73:113-119.

9. Torkington J, Smith SG, Rees B, Darzi A. The role of the basic surgical skills course in the acquisition and retention of laparoscopic skill. Surg Endosc 2001;15:1071-1075.

10. Derossis AM, Bothwell J, Sigman HH, Fried GM. The effect of practice on performance in a laparoscopic simulator. Surg Endosc 1998;12:1117-1120.

11. Adrales GL, Chu UB, Witzke DB, Donnelly MB, Hoskins D, Mastrangelo MJ Jr, et al. Evaluating minimally invasive surgery training using low-cost mechanical simulations. Surg Endosc 2003;17:580-585.

12. Hance J, Aggarwal R, Moorthy K, Munz Y, Undre S, Darzi A. Assessment of psychomotor skills acquisition during laparoscopic cholecystectomy courses. Am J Surg 2005;190:507-511.

13. Satava RM, Gallagher AG, Pellegrini CA. Surgical competence and surgical proficiency: definitions, taxonomy, and metrics. J Am Coll Surg 2003;196:933-937.

14. Hinojosa PA. Entrenamiento tutelar intensivo en colecistectomía laparoscópica en pacientes. Cir Gen 2000;22:334-336.

15. Stefanidis D, Korndorffer JR Jr, Sierra R, Touchard C, Dunne JB, Scott DJ. Skill retention following proficiency-based laparoscopic simulator training. Surgery 2005;138:165-170.

16. Korndorffer JR Jr, Stefanidis D, Scott DJ. Laparoscopic skills laboratories: current assessment and a call for resident training standards. Am J Surg 2006;191:17-22.

17. Uchal M, Raftopoulos Y, Tjugum J, Bergamaschi R. Validation of a six-task simulation model in minimally invasive surgery. Surg Endosc 2005;19:109-116.

18. Youngblood PL, Srivastava S, Curet M, Heinrichs WL, Dev P, Wren SM. Comparison of training on two laparoscopic simulators and assessment of skills transfer to surgical performance. J Am Coll Surg 2005;200:546-551.