Lubet Alexis, Renaux-Petel Mariette, Marret Jean-Baptiste, Rod Julien, Sibert Louis, Delbreilh Laurent, Liard Agnès
Department of Pediatric and Adolescent surgery, University Hospital of Rouen, 76000, Rouen, France.
Medical Training Center Rouen-Normandie, Rouen, France.
Heliyon. 2024 Nov 30;10(24):e40550. doi: 10.1016/j.heliyon.2024.e40550. eCollection 2024 Dec 30.
This study created and evaluated the face validity of a novel, low-cost, three-dimensional printed pediatric laparoscopic trainer and compared it to a standard laparoscopic trainer (LT).
We developed the Space Child Laparoscopic Trainer (SCLT) using fused deposition modeling technology with a Bambulab P1S 3D printer.The cost per unit was five euros and the assembly time was 10 min. The printing time was 543 min for 434 g of polylactic acid filament (PLA). A smartphone was used as the camera.The performance of experienced surgeons and surgical residents was evaluated on SCLT and LT using the Objective Structured Assessment of Technical Skill score (OSATS) and time spent. Two fundamental laparoscopic tasks, peg transfer and precision cutting, were randomly performed by each trainer. Participant satisfaction was assessed using a questionnaire. This study assessed the learning speed of surgical residents using the SCLT compared to a standard LT through a non-inferiority test. The test results were compared with those of a control group of experienced senior surgeons.
A medical training program was set up for first-year surgery residents from different French cities (Rouen, Caen, Amiens, and Lille) at the Medical Training Center of Rouen, in collaboration with the University Hospital of Rouen.
Ten pediatric surgeons with at least ten years of experience in laparoscopic surgery, 51 first-year surgical residents, and six external evaluators with at least five years of laparoscopic experience.
In total, 200 exercises were performed by 50 residents. The estimated learning speed was +0.139 (95 % confidence interval [CI]: +0.053-+0.252, p = 0.01) for LT and +0.153 (95%CI: +0.035-+0.243, p = 0.004) for SCLT. The estimated learning speed ratio for the SCLT compared to that for the LT was 1.10 (95%CI: 0.35-3.46, p = 0.09 for non-inferiority to 0.50).
The results demonstrated a similar performance between the SCLT and standard LT for resident training in pediatric surgery. The widespread dissemination of this tool to residents and surgeons, especially in developing countries, may allow easier access to laparoscopic training.
本研究制作并评估了一种新型低成本三维打印小儿腹腔镜训练器的表面效度，并将其与标准腹腔镜训练器（LT）进行比较。
我们使用Bambulab P1S 3D打印机的熔融沉积建模技术开发了太空儿童腹腔镜训练器（SCLT）。单位成本为5欧元，组装时间为10分钟。打印434克聚乳酸长丝（PLA）的时间为543分钟。使用智能手机作为摄像头。通过客观结构化技术技能评分（OSATS）和花费的时间，对经验丰富的外科医生和外科住院医师在SCLT和LT上的表现进行评估。每个训练器随机执行两项基本的腹腔镜任务，即移钉和精确切割。使用问卷评估参与者的满意度。本研究通过非劣效性测试评估了与标准LT相比，使用SCLT的外科住院医师的学习速度。将测试结果与经验丰富的资深外科医生对照组的结果进行比较。
与鲁昂大学医院合作，在鲁昂医学培训中心为来自法国不同城市（鲁昂、卡昂、亚眠和里尔）的一年级外科住院医师设立了一个医学培训项目。
10名具有至少10年腹腔镜手术经验的小儿外科医生、51名一年级外科住院医师和6名具有至少5年腹腔镜经验的外部评估人员。
50名住院医师共进行了200次练习。LT的估计学习速度为+0.139（95%置信区间[CI]：+0.053-+0.252，p = 0.01），SCLT的估计学习速度为+0.153（95%CI：+0.035-+0.243，p = 0.004）。与LT相比SCLT的估计学习速度比为1.10（95%CI：0.35-3.46，非劣效于0.50时p = 0.09）。
结果表明，在小儿外科住院医师培训中，SCLT和标准LT的表现相似。将此工具广泛传播给住院医师和外科医生，尤其是在发展中国家，可能会使腹腔镜培训更容易获得。
