One or two trainees per workplace for laparoscopic surgery training courses: results from a randomized controlled trial

Kowalewski, Karl‐Friedrich; Minassian, Andreas; Hendrie, Jonathan D.; Benner, Laura; Preukschas, Anas; Kenngott, Hannes; Fischer, Lars; Müller‐Stich, Beat P.; Nickel, Felix

doi:10.1007/s00464-018-6440-5

Cited by 27 publications

(49 citation statements)

References 46 publications

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“…2 and 3. To minimize the potential bias of two simultaneous participants at a training parkour described by Kowalewski et al [14], participants start in a “time delayed” manner. The display systems are placed 1.5 m away from each other.…”

Section: Methodsmentioning

confidence: 99%

3D vs. 4K Display System - Influence of “State-of-the-art”-Display Technique On Surgical Performance (IDOSP-Study) in minimally invasive surgery: protocol for a randomized cross-over trial

Wahba

Datta

Hedergott

et al. 2019

Trials

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Background Three-dimensional (3D) stereoscopic vision is crucial to perform any kind of manual task. The reduction from real life 3D to virtual two-dimensional (2D) sight is a major challenge in minimally invasive surgery (MIS). A 3D display technique has been shown to reduce operation time and mistakes and to improve the learning curve. Therefore, the use of a3D display technique seems to optimize surgical performance for novice and experienced surgeons. Inspired by consumer electronics, a 4K display technique was recently introduced to MIS. Due to its high resolution and zoom effect, surgeons should benefit from it. The aim of this study is to evaluate if “state-of-the-art” 3D- vs. 4K-display techniques could influence surgical performance. Methods A randomized, cross-over, single-institution, single-blinded trial is designed. It compares the primary outcome parameter “surgical performance”, represented by “performance time ”and “number of mistakes”, using a passive polarizing 3D and a 4K display system (two arms) to perform different tasks in a minimally invasive/laparoscopic training parkour. Secondary outcome parameters are the mental stress load (National Aeronautics and Space Administration (NASA) Task Load Index) and the learning curve. Unexperienced novices (medical students), non-board-certified, and board-certified abdominal surgeons participate in the trial (i.e., level of experience, 3 strata). The parkour consists of seven tasks (for novices, five tasks), which will be repeated three times. The 1st run of the parkour will be performed with the randomized display system, the 2nd run with the other one. After each run, the mental stress load is measured. After completion of the parkour, all participants are evaluated by an ophthalmologist for visual acuity and stereoscopic vision with five tests. Assuming a correlation of 0.5 between measurements per subject, a sample size of 36 per stratum is required to detect a standardized effect of 0.5 (including an additional 5% for a non-parametric approach) with a power of 80% at a two-sided type I error of 5%. Thus, altogether 108 subjects need to be enrolled. Discussion Complex surgical procedures are performed in a minimally invasive/laparoscopic technique. This study should provide some evidence to decide which display technique a surgeon could choose to optimize his performance. Trial registration ClinicalTrials.gov, NCT03445429. Registered on 7 February 2018.

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Section: Methodsmentioning

confidence: 99%

3D vs. 4K Display System - Influence of “State-of-the-art”-Display Technique On Surgical Performance (IDOSP-Study) in minimally invasive surgery: protocol for a randomized cross-over trial

Wahba

Datta

Hedergott

et al. 2019

Trials

View full text Add to dashboard Cite

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“…Many other multimodality trainers are being used and data has been published for them too, but as a single modality learning tool LAP Sim has shown the efficiency of completely incorporating the laparoscopic training curriculum in itself. It has provided similar levels of trainee performance as any other multi-modality training tool 10,11 .…”

Section: Discussionmentioning

confidence: 99%

Simulation Based Training Improves Laparoscopic Surgical Skills in Trainee Surgeons

Shaikh

Khaliq

2021

PAFMJ

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Objective: To assess the impact of laparoscopic simulation training on surgical skills of trainee surgeons. Study Design: Comparative prospective study. Place and Duration of Study: Jinnah Sindh Medical University Karachi, for one month October 2019. Methodology: Total thirty surgical trainees of FCPS year four (R4) were studied. The cases group (fifteen trainees) were given one month laparoscopy training on a LAP Simulator (LAPSim), surgical science Sweden) and the control group (fifteen trainees) were not trained. Their laparoscopic skills were then compared. Objective Structured Assessment of Technical Skills (OSATS) specific and general was used to assess their performance. Data was entered and analyzed using SPSS-23. Results: On LAP Sim Scoring, post-test scores were significantly better than pre-test for all skills in the trainedresidents (p<0.01 for all subscales) and total post-test score was also significantly better for trained surgeonsas compared to untrained (77.45 ± 7.78 vs. 31.70 ± 2.48; p<0.01). On Objective Structured Assessment of Technical Skills for specific tasks, post-test scores were significantly better than pre-test for all tasks in the cases (p<0.01 for all subscales) and for none in the controls. On Objective Structured Assessment of Technical Skills general, posttest scores were significantly better than pre-test for all tasks in the cases (p<0.01 for all subscales) and for clip application (p<0.01) and suturing with intracorporeal knot tying (p<0.01) in the controls. Conclusion: This study demonstrated significantly improved levels of performance for all skill sets for novicesurgical residents trained on LAP Sim for minimally invasive surgical procedures.

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“…The training as a unit of two trainees per simulator has been proven efficient in laparoscopic simulation compared to training alone. [ 8 ] Furthermore, training as an interactive team (camera assistant and surgeon) improves collaboration and performance parameters in a VRL setup. [ 3 ]…”

Section: Discussionmentioning

confidence: 99%

Higher quality camera navigation improves the surgeon's performance: Evidence from a pre-clinical study

et al. 2020

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Introduction: To objectively assess the quality of laparoscopic camera navigation (LCN), the structured assessment of LCN skills (SALAS) score was developed and validated for laparoscopic cholecystectomy. The aim of this pre-clinical study was to investigate the influence of LCN on surgical performance during virtual cholecystectomy (vCHE) using this score. Methods: A total of 84 medical students were included in this prospective study. Individual characteristics were assessed with questionnaires. Participants completed a structured 2-day training course on a validated virtual reality laparoscopic simulator. At the end of the course, all students took over LCN during vCHE, all performed by the same surgeon. The numbers of errors regarding centering, horizon adjustment and instrument visualisation as well as manual and verbal corrections by the surgeon were recorded to calculate the SALAS score (range 5–25) to investigate the influence of LCN on surgical performance. The study population was divided by the recorded SALAS score into low and medium performers (Group A; 1 st –3 rd quartile; n = 60) and high performers (Group B, 4 th quartile, n = 21). Results: The SALAS score of the camera assistant correlates positively with the surgeon's overall performance in vCHE ( P < 0.001), and the surgeon's virtual laparoscopic performance was significantly better in Group B ( P < 0.001). Moreover, a significantly shorter operation time during vCHE was shown for Group B (Median (IQR); Group A: 508 s [429 s; 601 s]; Group B: 422 s [365 s; 493 s]; P = 0.001). Frequent gaming and a higher self-confidence to assist during a basic laparoscopic procedure were associated with a higher SALAS score ( P = 0.013). Conclusion: In this pre-clinical setting, the surgeon's virtual performance is significantly influenced by the LCN quality. LCN by high performers resulted in a shorter operation time and a lower error rate.

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One or two trainees per workplace for laparoscopic surgery training courses: results from a randomized controlled trial

Cited by 27 publications

References 46 publications

3D vs. 4K Display System - Influence of “State-of-the-art”-Display Technique On Surgical Performance (IDOSP-Study) in minimally invasive surgery: protocol for a randomized cross-over trial

3D vs. 4K Display System - Influence of “State-of-the-art”-Display Technique On Surgical Performance (IDOSP-Study) in minimally invasive surgery: protocol for a randomized cross-over trial

Simulation Based Training Improves Laparoscopic Surgical Skills in Trainee Surgeons

Higher quality camera navigation improves the surgeon's performance: Evidence from a pre-clinical study

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