Mangray Hansraj, Madziba Sanele, Harilal Shamaman, Govender Yashlin, Ngobese Amanda, Clarke Damian L
Department of Paediatric Surgery, Grey's Hospital, University of KwaZulu-Natal, Pietermaritzburg, South Africa.
Department of Surgery, Grey's Hospital, University of KwaZulu-Natal, Pietermaritzburg, South Africa.
Surg Pract Sci. 2023 Dec 4;15:100229. doi: 10.1016/j.sipas.2023.100229. eCollection 2023 Dec.
We developed a home-based laparoscopic suturing simulation (HBLSS) technique, which is intended to improve the impact of a structured laparoscopic training course.
A group of sixteen students were provided with the educational video, and after two weeks, all students were observed and timed performing a laparoscopic reef knot. The students were then randomized into two cohorts. The exclusive video group continued using the video for a further two weeks. The second group were shown the HBLSS technique and told to use this in conjunction with the video for a further two weeks.
The entire cohort had an initial median time to form an intracorporeal reef knot of 190 s (range 459, IQR 128). After two additional weeks of using the educational video exclusively, the median time was reduced to 85 s (range 282, IQR 125), whereas the HBLSS and educational video group had a median post-training time of 28.5 s (range 36, IQR 18.5). There was a clear statistical difference between the exclusive video group and the HBLSS and video group ( = 0.008). There was also an improvement from the movement of both instruments to one instrument, reduced crossing of instruments and reduced transverse movement in the HBLSS and video group.
A combination of video-based teaching and HBLSS was associated with improved laparoscopic intra-corporeal knot-tying skills in comparison to the exclusive video-based teaching. This reflects the importance of imparting both cognitive and psychomotor skills to students practising laparoscopic surgery.
我们开发了一种基于家庭的腹腔镜缝合模拟（HBLSS）技术，旨在提高结构化腹腔镜培训课程的效果。
为一组16名学生提供了教学视频，两周后，观察所有学生并记录他们进行腹腔镜平结操作的时间。然后将学生随机分为两组。仅视频组继续使用视频两周。第二组观看了HBLSS技术，并被告知在接下来的两周内将其与视频结合使用。
整个队列最初形成体内平结的中位时间为190秒（范围459，四分位间距128）。仅使用教学视频两周后，中位时间缩短至85秒（范围282，四分位间距125），而HBLSS与教学视频组训练后的中位时间为28.5秒（范围36，四分位间距18.5）。仅视频组与HBLSS和视频组之间存在明显的统计学差异（P = 0.008）。HBLSS和视频组在器械操作从双手操作变为单手操作、器械交叉减少以及横向移动减少方面也有改善。
与仅基于视频的教学相比，基于视频的教学与HBLSS相结合可提高腹腔镜体内打结技能。这反映了向练习腹腔镜手术的学生传授认知和心理运动技能的重要性。
