Measuring laparoscopic operative skill in a video trainer |
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Authors: | M Black J C Gould |
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Institution: | (1) Department of Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, K4/762 Clinical Science Center, Madison, WI, 53792 |
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Abstract: | Background Laparoscopic surgery requires a unique set of technical skills. More experienced laparoscopic surgeons perform certain tasks
more efficiently in a video trainer than less experienced laparoscopic surgeons. The presumption is that the experienced surgeon
possesses more of the skill required to complete the task. This study sought to determine the degree to which previous laparoscopic
operative experience influenced the performance of selected video trainer tasks of varying complexity.
Methods In this study, 19 general surgery residents with varying levels of laparoscopic operative case experience (as defined by operative
case logs) were timed performing five tasks in a video trainer. The tasks were rope pass, peg drop, peg exchange, needle pass,
and knot tie. All the residents watched a video demonstration of each skill before testing. None of the residents had previous
exposure to video trainers, and no practice was allowed before testing. A composite score for all tasks was calculated for
each resident as a measure of overall performance.
Results There was a strong correlation between operative experience and time required for successful completion of each task, with
the exception of the rope pass. The magnitude of correlation increased with tasks of increasing complexity. Composite scores
were correlated with operative experience. Significant interval improvements in performance were observed for increasing experience
up to a level of approximately 100 previous laparoscopic cases.
Conclusions Overall composite scores and time required for the completion of each individual video trainer task (with the exception of
the rope pass) may be an accurate reflection of laparoscopic surgical skill acquired in the operating room. A resident may
need as many as 100 laparoscopic cases for full development of a basic skill set in the operating room. A more efficient and
safe method of training, such as a validated skills curriculum conducted in a dry lab, is a desirable alternative to developing
skill exclusively in the operating room. |
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Keywords: | Laparoscopic experience Laparoscopic training Video trainer |
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