medigraphic.com
ISSN 1665-2576 (Print)

2011, Number 1

<< Back Next >>

Rev Mex Cir Endoscop 2011; 12 (1)

Reliability and validity of low-cost inanimate simulators for the development of basic skills in minimally invasive surgery

González-Ruiz V, González-Calatayud M, Justo-Janeiro J, Valadez-Caballero D, Santana-Domínguez MD

Language: Spanish
References: 12
Page: 23-30
PDF size: 152.30 Kb.


ABSTRACT

Introduction: Over the last decades, simulators and laboratory training have been used to gain surgical skills for minimally invasive surgery. Material and methods: 276 residents of different surgical specialties, using a low cost simulator, plus conventional laparoscopic instruments, for 15 days, 4 hours a day; with evaluations by an expert surgeon at the first, 8th and 15th days . 4 basic exercises were examined: 1 (fine movements), 2 (dissection), 3 (traction) and 4 (intracorporeal knots). Results: Exercise 1: statistical difference from day 1 to 15th, 35.4% with p value ‹ 0.0001, no statistical significance regarding specialties. Exercise 2: The decrease of the time on average from day 1 to day 15 was 68%, with a significant p in both measurements. Exercise 3: 43% less time from the beginning to the 15th day with a significant p ‹ 0.0001. Exercise 4: the only one where there were significant differences among residents to start with, nevertheless, they were not constant through the end of the trial; in general, there was significant difference in time throughout the study. Conclusion: In every exercise and session, we found significant difference with a p value less than 0.0001 throughout the study. Among residents, there were no significant differences.


REFERENCES

  1. Tang B, Hanna GB, Cuschieri A. Analysis of errors enacted by surgical trainees during skills training courses. Surgery; 2005; 138: 14-19.

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

  3. Fieldman LS, Hagarty SE, Guitulescu G, Stanbridge DD, Fried GM. Relationship between objective assessment of technical skills and subjective in-training evaluations in surgical residents. J Am Coll Surg 2004; 198: 105-110.

  4. Fried GM, Feldman LS, Vassiliou MC, Fraser SA, Stanbridge DD, Ghitulescu G, Andrew C. Proving the value of simulation in laparoscopic surgery. Ann Surg 2004; 40: 518-528.

  5. Peters JH, Fried GM, Swanstrom LL, Soper NJ, Silli LF, Schirmer B, Hoffman K, SAGES FLS Commitee. Development and validation of comprehensive program of education and assessment of basic fundamentals of laparoscopic surgery. Surgery 2004; 135: 21-27.

  6. McCluney AL, Vassiliou MC, Kaneva PA, Cao J, Stanbridge DD, Feldman LS, Fried GM. FLS simulator performance predicts intraoperative laparoscopic skills. Surg Endosc 2007; 21: 1991-1995.

  7. Vassiliou CM, Feldman LS, Andrew GC, Bergman S, Leffondre K, Stanbridge D, Fried MG. A global assessment tool for evaluation of intraoperative laparoscopic skills. Am J Surg 2005; 190: 107-113.

  8. Korndorffer JR, Hayes DJ, Dunne JB, et al. Development and transferability of cost-effective laparoscopic camera navigator simulator. Surg Endosc 2005; 19: 161-167.

  9. Scott JD, Bergen CP, Rege VR et al. Laparoscopic training on bench models: Better and more cost effective than operating room experience? Am Coll Surg 2000; 191: 272-285.

  10. Adrales GL, Chu UB, Witzke DB et al. Evaluation minimally invasive surgery training using low-cost mechanical simulations. Surg Endosc 2003; 17: 580-585.

  11. Youngblood LP, Srivastava S, Curet M, Heinrichs WL, Parvati D. Wren MS. Comparison on training on to laparoscopic simulators and assessment of skills transfer to surgical performance. J Am Coll Surg 2005; 200: 546-551.

  12. Korndorffer JR, Scott DJ, Sierra R, Brunner CW, Dunne JB, Slakey PD, Townsend CM, Hewitt LR. Development and testing competency leves for laparoscopic skills training. Arch Surg 2005; 140: 80-85.




2020     |     www.medigraphic.com