Training for advanced laparoscopic surgery.

OBJECTIVE: To evaluate the efficiency of training for advanced minimally-invasive surgery in rats. SETTING: Teaching hospital, Germany. SUBJECTS: 10 surgical residents with few laparoscopic training skills had two days laparoscopic microsurgical training using rats. INTERVENTIONS: Increasingly difficult procedures started using a rubber model, followed by 'open' and 'closed' rat models simulating laparoscopic conditions. MAIN OUTCOME MEASURES: The surgical skills of all participants were assessed before and after the laparoscopic training course by applying 5 defined tasks in a simulation trainer. As a control group, 8 surgical residents with the same amount of minimal-invasive training were tested after a 2-day interval. RESULTS: All participants of the laparoscopic training programme significantly improved their surgical skills for all 5 tasks (p < 0.05). In the control group only one of the 5 tasks was significantly improved after repetition. Participants of the complete training programme consistently improved their surgical skills significantly compared with the controls before and after repetition (p < 0.05). CONCLUSION: Surgical training in minimal-invasive techniques in the rat model is effective and reproducible especially to improve laparoscopic skills such as bimanual tissue handling, knot tying and microsurgical suturing.