409 Evaluation of Advanced Bimanual Skills in Novices Using the Wrist-Like FlexDex™ Articulating Laparoscopic Needle Holder in 2D and 3D Vision: A Randomised Trial

Abstract

Aim The aim of this study was to evaluate the novice performance of advanced bimanual laparoscopic skills using the articulating FlexDex™ laparoscopic needle holder in two-dimensional (2D) and three-dimensional (3D) visual systems. Method In this prospective randomised trial, novices (n=40) without laparoscopic experience were recruited from a university cohort and randomised into two groups, which used the FlexDex™ and 2D or the FlexDex™ and 3D. Both groups performed 10 repetitions of a validated assessment task. Times taken and error rates were measured, and assessments were made based on completion times, error rates and learning curves. Results The intervention group that used FlexDex™ and 3D visual output completed 10 attempts of the standardised laparoscopic task quicker than the control group that used FlexDex™ with standard 2D visual output (268 seconds vs 415 seconds taken for the first three attempts and 176 seconds vs 283 seconds taken for the last three attempts, respectively). Moreover, each attempt was completed faster by the intervention group compared to the control group. The difference in average time for the first three and last three attempts reached statistical significance (P < 0.001). Conclusion Combination of 3D visual systems and the FlexDex™ laparoscopic needle holder resulted in superior task performance speed, leading to shorter completion times and quicker learning effect. Although the 3D group demonstrated lower mean error rates, it did not reach statistical significance.

Plastic Surgery Teaching to United Kingdom Undergraduate Medical Students: A Systematic Review

“…Students would also have the opportunity to ask questions as the surgery proceeded. Further, 7 of the 15 studies recommended a voluntary form of teaching 9 11 12 13 14 16 2-, 5 recommended compulsory teaching, 10 15 17 18 22 and 3 suggested both. 8 19 21…”

“…A drawback of this systematic review is that 12/15 of the studies 8 9 10 11 12 13 14 15 16 18 19 20 were deemed to have a high risk of bias. This is because two were letters to the editor, 19 20 with no cross-sectional study performed and were thus viewed as being highly opinionated.…”

“…This is because two were letters to the editor, 19 20 with no cross-sectional study performed and were thus viewed as being highly opinionated. Most of the cross-sectional studies, 8 9 10 11 12 13 14 15 16 18 apart from the study by Wade et al, 17 were also deemed as being at high risk of bias: this is because they all had small sample sizes and the data analysis was done with no blinding or control; for example, the organizers of the intervention (such as a plastic surgery teaching course) did the data analysis. The cross-sectional study by Wade et al 17 was deemed as being at low risk of bias as it was a nationwide study with a large sample size.…”

“…Forty-one abstracts were identified; following this, the full texts were screened, after which 15 studies were identified. 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Any studies that did not fulfil the inclusion criteria or fulfilled the exclusion criteria were removed from the search. See Fig.…”

“…Of the 15 studies that were included in this systematic review, 11 were cross-sectional studies, 8 9 10 11 12 13 14 15 16 17 18 2 were letters to the editor, 19 20 1 was a comparative study, 21 and 1 was a pilot study. 22 All the studies were published in English and were published after 2011.…”