Teaching surgery novices and trainees advanced laparoscopic suturing: a trial and tribulations
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and Other Interventional Techniques
2020 SAGES POSTER
Teaching surgery novices and trainees advanced laparoscopic suturing: a trial and tribulations Arianne T. Train1 · Jinwei Hu1 · J. Reinier F. Narvaez1 · Lorin M. Towle‑Miller2 · Gregory E. Wilding2 · Lora Cavuoto3 · Katia Noyes4 · Aaron B. Hoffman1 · Steven D. Schwaitzberg1 Received: 7 April 2020 / Accepted: 29 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Introduction The benefits of minimally invasive surgery are numerous; however, considerable variability exists in its application and there is a lack of standardized training for important advanced skills. Our goal was to determine whether participation in an advanced laparoscopic curriculum (ALC) results in improved laparoscopic suturing skills. Methods and procedures Study design was a prospective, randomized controlled trial. Surgery novices and trainees underwent baseline FLS training and were pre-tested on bench models. Participants were stratified by pre-test score and randomized to undergo either further FLS training (control group) or ALC training (intervention group). All were post-tested on the same bench model. Tests for differences between post-test scores of cohorts were performed using least squared means. Multivariable regression identified predictors of post-test score, and Wilcoxon rank sum test assessed for differences in confidence improvement in laparoscopic suturing ability between groups. Results Between November 2018 and May 2019, 25 participants completed the study (16 females; 9 males). After adjustment for relevant variables, participants randomized to the ALC group had significantly higher post-test scores than those undergoing FLS training alone (mean score 90.50 versus 82.99, p = 0.001). The only demographic or other variables found to predict post-test score include level of training (p = 0.049) and reported years of video gaming (p = 0.034). There was no difference in confidence improvement between groups. Conclusions Training using the ALC as opposed to basic laparoscopic skills training only is associated with superior advanced laparoscopic suturing performance without affecting improvement in reported confidence levels. Performance on advanced laparoscopic suturing tasks may be predicted by lifetime cumulative video gaming history and year of training but does not appear to be associated with other factors previously studied in relation to basic laparoscopic skills, such as surgical career aspiration or musical ability. Keywords Surgical education · Minimally invasive surgery · Advanced laparoscopy · Advanced laparoscopic curriculum
* Arianne T. Train [email protected] 1
Department of Surgery, University at Buffalo, State University of New York Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
2
Department of Biostatistics, University at Buffalo, State University of New York School of Public Health and Health Professions, Buffalo, NY, USA
3
Department of Industrial and Systems Engineering
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