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2025, Number 1-4

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Rev Mex Cir Endoscop 2025; 26 (1-4)

Utility of the skills simulator in structured training of laparoscopic procedures

Valadez-Caballero D, Urbina-Cabello JJ, Salinas-Ocampo C, Alvarado-Durán J, Cristóbal-Luna JM

Language: Spanish
References: 27
Page: 9-17
PDF size: 1500.26 Kb.


ABSTRACT

Introduction: simulation-based training is an effective technique for enhancing skills in a curriculum focused on developing competencies in general surgery. The aim of this study was to evaluate the acceptability and effectiveness of a structured simulation training program for developing laparoscopic skills. Material and methods: the experimental study involved 47 participants, a structured training and evaluation module was designed and validated, spanning 20 weeks on laparoscopic simulation trainers, with training sessions lasting 1 to 2 hours under the guided supervision of experienced instructors. Pre- and post-training scores and times were compared using paired t-tests, two-way ANOVA post hoc Student–Newman–Keuls (SNK), and ANOVA on ranks, depending on the data obtained, utilizing SigmaPlot 14.0 for statistical significance. Results: the study evaluated 47 participants, comprising 23 certified surgeons and 24 general surgery residents; but within-group comparisons revealed improvements in performance times and skill levels at the end of the training, with notable enhancements in scores and task completion times based on the exercises and skills assessed. Conclusions: the implementation of an easy-to-use simulator provides significant training and evaluation during surgical education, facilitating learning before progressing to anatomical models and subsequently performing procedures on real patients.


REFERENCES

  1. Castillo-Castellanos R, Pérez-García R, García-Álvarez J, Álvarez-Cordero R. La importancia de la cirugía laparoscópica para el cirujanogeneral. Salud en Tabasco. 2006; 12: 443-448.

  2. Quirarte CC, Muñoz HJD. La revolución pedagógica en la cirugía, Parte III. Metodología de la enseñanza de destrezas psicomotoras: los simuladores. Rev Mex Cir Endoscop. 2013; 14: 37-51.

  3. Reznick RK, MacRae H. Teaching surgical skills-changes in the wind. N Eng J Med. 2006; 355: 2664-2669.

  4. de Kailash C, Nath MJ. Simulation-based structured training for developing laparoscopy skills in general surgery and obstetrics & gynecology postgraduates. J Educ Health Promot. 2021; 10: 387.

  5. Scott DJ, Young WN, Tesfay ST, Frawley WH, Rege RV, Jones DB. Laparoscopic skills training. Am J Surg. 2001; 182: 137-142.

  6. Satava RM. Surgical education and surgical simulation. World J Surg. 2001; 25: 1484-1489.

  7. Ramos-Tovar DR, Salinas SA. Simuladores virtuales para entrenamiento de habilidades para laparoscopía. Rev Ing Biomed. 2016; 10: 45-55.

  8. Zhang J, Luo Z, Zhang R, Ding Z, Fang Y, Han C et al. The transition of surgical simulation training and its learning curve: a bibliometric analysis from 2000 to 2023. Int J Surg. 2024; 110: 3326-3337.

  9. Grantcharov TP, Bardram L, Funch-Jensen P, Rosenberg J. Learning curves and impact of previous operative experience on performance on a virtual reality simulator to test laparoscopic surgical skills. Am J Surg. 2003; 185:146–149.

  10. Aggarwal R, Grantcharov TP, Eriksen JR, Blirup D, Kristiansen VB, Funch-Jensen P et al. 2006. An evidence-based virtual reality training program for novice laparoscopic surgeons. Ann Surg. 2006; 244: 310-314.

  11. Ebina K, Abe T, Hotta K, Higuchi M, Furumido J, Iwahara N et al. 2022. Objective evaluation of laparoscopic surgical skills in wet lab training based on motion analysis and machine learning. Langenbecks Arch Surg. 2022; 407: 2123-2132.

  12. Vassiliou MC, Feldman LS, Andrew CG, Bergman S, Leffondré K, Stanbridge D et al. A global assessment tool for evaluation of intraoperative laparoscopic skills. Am J Surg. 2005; 190: 107-113.

  13. Nagendran M, Gurusamy KS, Aggarwal R, Loizidou M, Davidson BR. Virtual reality training for surgical trainees in laparoscopic surgery. Cochrane Database Syst Rev. 2013; 2013: CD006575.

  14. Mannella P, Malacarne E, Giannini A, Russo E, Caretto M, Papini F et al. Simulation as tool for evaluating and improving technical skills in laparoscopic gynecological surgery. BMC Surg. 2019; 19: 146.

  15. Al-Kadi AS, Donnon T, Oddone-Paolucci E, Mitchell P, Debru E, Church N. The effect of simulation in improving students' performance in laparoscopic surgery: a meta-analysis. Surg Endosc. 2012; 26: 3215-3224.

  16. Torricelli FC, Barbosa JA, Marchini GS. Impact of laparoscopic surgery training laboratory on surgeon's performance. World J Gastrointest Surg. 2016; 8: 735-743.

  17. McCluney AL, Vassiliou MC, Kaneva PA, Cao J, Stanbridge DD, Feldman LS et al. FLS simulator performance predicts intraoperative laparoscopic skill. Surg Endosc. 2007; 21: 1991-1995. doi: 10.1007/s00464-007-9451-1.

  18. Sroka G, Feldman LS, Vassiliou MC, Kaneva PA, Fayez R, Fried GM. Fundamentals of laparoscopic surgery simulator training to proficiency improves laparoscopic performance in the operating room-a randomized controlled trial. Am J Surg. 2010; 199: 115-120.

  19. Imaizumi K, Ichikawa N, Homma S, Yamamoto K, Ishizuka C, Takahashi R et al. Effect of continuous box-trainer training on laparoscopic skills of surgical residents: a prospective, observational study. In Vivo. 2023; 37: 476–482.

  20. Hassan L, Maschuw K, Rothmund M, Koller M, Gerdes B. Novices in surgery are the target group of a virtual reality training laboratory. Eur Surg Res. 2006; 38(2): 109-13.

  21. Moore AK, Grow DR, Bush RW, Seymour NE. Novices Outperform Experienced Laparoscopists on Virtual Reality Laparoscopy Simulator. JSLS. 2008;12(4): 358-362.

  22. Fraser SA, Klassen DR, Feldman LS, Ghitulescu GA, Stanbridge D, Fried GM. Evaluating laparoscopic skills: setting the pass/fail score for the MISTELS system. Surg Endosc. 2003; 17: 964-967.

  23. Crihfield EG, Uppalapati P, Abittan B, Laibangyang A, Brahmbhatt S, Burlingame M, et al. Development of laparoscopic skills in skills-naïve trainees using self-directed learning with take-home laparoscopic trainer boxes. Surg Open Sci. 2023; 16: 82-93.

  24. Caban AM, Guido C, Silver M, Rossidis G, Sarosi G, Ben-David K. Use of collapsible box trainer as a module for resident education. JSLS. 2013; 17: 440-444.

  25. Badash I, Burtt K, Solorzano CA, Carey JN. Innovations in surgery simulation: a review of past, current and future techniques. Ann Transl Med. 2016; 4: 453.

  26. Zundel S, Singer N, Florinett L, Aichner J, Jhala T, Szavay P. Development and assessment of a loop ligation simulator for laparoscopic appendectomy. Pediatr Surg Int. 2024; 40: 86.

  27. Al-Elq AH. Simulation-based medical teaching and learning. J Family Community Med. 2010; 17: 35-40.




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