Fundamentals of Laparoscopic Surgery: A Surgical Skills Assessment Tool in Gynecology

Abstract

This analysis suggests that the fundamentals of laparoscopic surgery skills test may be a valuable assessment tool for gynecology residents; however, the cognitive test may need further adaptation for application to gynecologists.

2D Versus 3D Visualization: Impact on Laparoscopic Proficiency Using the Fundamentals of Laparoscopic Surgery Skill Set

“…Developed by SAGES 15 and endorsed by the American College of Surgeons, 18,19 the FLS program has now been validated as a laparoscopic surgical skill assessment and training tool in multiple studies across specialty lines. 16,18,20,21 Fried et al 15 demonstrated that FLS scores increased progressively with increasing laparoscopic experience among general surgeons (n = 215, P < .0001) and that surgery residents followed over time increased their FLS scores (n = 24, P < .0001), thus providing evidence of construct validity. The same study also found that FLS scores correlated with a highly reliable validated intraoperative rating of technical skill during laparoscopic cholecystectomy (n = 19, r = 0.81, P < .0004), evidence of concurrent validity, and, because results in the host institution did not differ from those in five other sites evaluated (n = 215), evidence of external validity.…”

“…The same study also found that FLS scores correlated with a highly reliable validated intraoperative rating of technical skill during laparoscopic cholecystectomy (n = 19, r = 0.81, P < .0004), evidence of concurrent validity, and, because results in the host institution did not differ from those in five other sites evaluated (n = 215), evidence of external validity. 15 Hurr et al 20 validated the FLS program among gynecology residents, demonstrating a significant difference in FLS pass rates favoring the more senior residents (P = .007), as well as a strong correlation between self-reported surgical experience and FLS skills scores (r = 0.97, P = .0048). Similarly, the use of the FLS skills curriculum for assessing laparoscopic skills among urologists was validated in a study by Sweet et al 18 In this study, investigators demonstrated that practicing clinical urologists (n = 81) outperformed residents and medical students (n = 35) in time to completion of the circle cutting exercise (P < .01) and that practicing urologists who reported more than three laparoscopic procedures per week were faster at the peg-transfer exercise (P < .05) and circle cutting exercise (P < .01) than those reporting less than three procedures.…”

“…[15][16][17] Branded as the ''Fundamentals of Laparoscopic Surgery'' (FLS) program, this curriculum has been validated by multiple studies across surgical specialities as a laparoscopic surgical skill assessment and training tool. 15,16,[18][19][20][21] We, therefore, sought to compare the impact of 2D versus 3D visualization on laparoscopic performance using components of the validated FLS skill set.…”

Surgical Skills Simulation Center Implementation: Healthcare Continuous Quality Improvement Project

“…Simulation programs are also accepted as annual improvement in medical practice modules for board certified ObGyns' MOC. FLS incorporation into gynaecologic residency program training has been recommended [33]. Structured robotic simulation may become a mandatory component of surgical specialty residency programs [34].…”

“…Departments must determine the logistics of incorporating the SSSC program into the residents' schedules [49]. Residency FLS programs require 24-hour access SSSC [33]. Plan-do-study-act (PDSA) cycles may be necessary to determine which equipment, curricula, learners, and learning schedule should be introduced, and the manner in which this occurs.…”