Department of Obstetrics and Gynecology, La Conception Hospital, Aix Marseille University, Marseille, France.
Department of Obstetrics and Gynecology, La Conception Hospital, Aix Marseille University, Marseille, France.
J Surg Educ. 2017 Nov-Dec;74(6):1019-1027. doi: 10.1016/j.jsurg.2017.05.013. Epub 2017 Jun 16.
Training on laparoscopic box trainer (BT) improves suturing skills in the operating room (OR). Optimal laboratory training should provide trainees with an adequate level of skills that can be transferred to the OR with no decline in performances. This study aimed to compare OR intracorporeal suturing performances of residents who trained with a fundamentals of laparoscopic surgery (FLS) BT vs. those of experienced laparoscopists.
This was a prospective observational study. Residents received training with an FLS BT over a period of 4 months. Their performances with the BT and in the OR were then compared with those of experienced senior surgeons. OR assessment took place during a laparoscopic myomectomy. Performance evaluation was based on time taken and 2 validated qualitative assessment tools (GOALS and the Moorthy checklist).
One academic tertiary care center, La Conception Hospital, Assistance Publique -Hopitaux de Marseille, Marseille, France, was involved.
Twelve gynecology residents and 6 experienced laparoscopic surgeons.
Following the FLS training period, performances of residents with the BT were equivalent to those of the experienced surgeons. When tested in the OR, the trained residents performed more slowly than experienced surgeons (279.75 vs. 159.75s; p = 0.001), and they obtained lower qualitative outcomes in terms of GOALS (13 vs. 16.75; p = 0.002) and checklist (18.25 vs. 21; p = 0.049). Transfer from the BT to the OR revealed an increase in time taken that was significantly higher for the trained residents' group than for the experienced group (137s vs. 49s; p < 0.001).
A performance gap emerged between trained residents and experienced surgeons when transferring from the BT to the OR. Finding an intermediate training platform between the BT and independently suturing in the OR is hence warranted.
在腹腔镜箱式训练器（BT）上进行培训可以提高手术室（OR）的缝合技能。最佳的实验室培训应该为学员提供足够水平的技能，这些技能可以在 OR 中应用，而不会降低性能。本研究旨在比较接受腹腔镜基础手术（FLS）BT 培训的住院医师和经验丰富的腹腔镜医师在 OR 中进行腔内缝合的表现。
这是一项前瞻性观察研究。住院医师接受了为期 4 个月的 FLS BT 培训。然后，将他们在 BT 和 OR 中的表现与经验丰富的高级外科医生进行比较。OR 评估在腹腔镜子宫肌瘤剔除术中进行。绩效评估基于时间和 2 个经过验证的定性评估工具（GOALS 和 Moorthy 清单）。
法国马赛公共援助-马赛大学附属医院拉孔切医院。
12 名妇科住院医师和 6 名经验丰富的腹腔镜外科医生。
在接受 FLS 培训后，住院医师使用 BT 的表现与经验丰富的外科医生相当。当在 OR 中进行测试时，接受培训的住院医师比经验丰富的外科医生慢（279.75 秒对 159.75 秒；p=0.001），并且在 GOALS（13 对 16.75；p=0.002）和清单（18.25 对 21；p=0.049）方面获得的定性结果较低。从 BT 到 OR 的转移表明，接受培训的住院医师组的用时增加幅度明显高于经验丰富的外科医生组（137 秒对 49 秒；p<0.001）。
从 BT 到 OR 的转移中，受训住院医师和经验丰富的外科医生之间出现了表现差距。因此，有必要在 BT 和 OR 中独立缝合之间找到一个中间培训平台。
