Are gynecologists sufficiently trained and educated on electro surgery and basic laparoscopic setting?

Abstract

Basic knowledge of electrosurgery and patient's safety during laparoscopic setup are fundamental, as laparoscopic surgical skills do. The aim of this prospective case-control study was to assess the improvement of such knowledge and skills among gynecologists. Gynecologists attending a training course on laparoscopy at the Centre International de Chirurgie Endoscopique (CICE), Clermont Ferrand (France) (December 2013-March 2014) were asked to answer a questionnaire about their own clinical activity and basic surgical knowledge and skills at the beginning and end of the course. The questionnaire included multiple choice questions about technical (four questions) and safety (five questions) aspects of laparoscopic set up and electrosurgery (five questions). Sixty-two residents and 68 graduated gynecologists completed pre- and post-course questionnaires (PrQ and PoQ, respectively). Considering 9 as an arbitrary cut-off score indicating an adequate theoretical knowledge, a total of 70 (51.8%) and 128 (94.8%) participants had a sufficient score at the PrQ and PoQ, respectively. Only 9.6% of participants were able to complete PoQ without making any mistakes, with a mean PrQ score of 9.5. At the beginning, the most difficult steps in laparoscopy in participants' opinion were intra-corporeal suture and insufflation of pneumoperitoneum (both 36.1%). After the course and the practical training, only 20% of participants still indicated intra-corporeal suture as the most difficult. Education on electro surgery and basic laparoscopic setting and laparoscopic practical training are necessary to improve and maintain laparoscopic surgical skills. The assessment of that knowledge is mandatory to define surgical competence.