Abstract
BackgroundConstruct validity of virtual laparoscopic simulators for basic laparoscopic skills has been proposed; however, it is not yet clear whether the simulators can identify the actual experience of surgeons in more complex procedures such as laparoscopic Roux-en-Y gastric bypass. This study tested the ability of the Lap Mentor simulator to recognize the experience in advanced laparoscopic procedures and to assess its role in the certification of bariatric surgeons.MethodsTwenty surgeons were divided into two groups according to their experience in laparoscopic and bariatric surgery. The general group included 10 general surgeons performing between 75 and 100 nonbariatric laparoscopic procedures. The bariatric group included 10 bariatric surgeons performing between 50 and 100 laparoscopic bariatric procedures. Participants were tested on the simulator in one basic task (task 1: eye–hand coordination) and in two tasks of the gastric bypass module (task 2: creation of the gastric pouch; task 3: gastrojejunal anastomosis).ResultsComparing the groups, no significant differences were found in task 1. Analyzing the results from the gastric bypass module (bariatric vs. general), in task 2, significant differences (p < 0.05) were found in the median volume of the gastric pouch (21 vs. 48 cm3), in the percentage of fundus included in the pouch (8.4 vs. 29.4 %), in the complete dissection at the angle of His (10 vs. 3), and in safety parameters. In task 3, significant differences were found in the size and position of enterotomies.ConclusionsThe Lap Mentor may be proposed as a certification tool for bariatric surgeons because it also recognizes their specific skills in the technical details of the procedure that affect long-term results. Furthermore, the possibility of analyzing the performance in detail can help define areas where the surgeon is lacking. These findings indicate a potential role of the Lap Mentor in tailoring the training to maximize improvement.
Highlights
Background Construct validity of virtual laparoscopic simulators for basic laparoscopic skills has been proposed; it is not yet clear whether the simulators can identify the actual experience of surgeons in more complex procedures such as laparoscopic Roux-en-Y gastric bypass
Vestri Department of Public Health and Infectious Disease, ‘‘Sapienza’’ – University of Rome, Rome, Italy bypass module, in task 2, significant differences (p \ 0.05) were found in the median volume of the gastric pouch (21 vs. 48 cm3), in the percentage of fundus included in the pouch (8.4 vs. 29.4 %), in the complete dissection at the angle of His (10 vs. 3), and in safety parameters
The Lap Mentor may be proposed as a certification tool for bariatric surgeons because it recognizes their specific skills in the technical details of the procedure that affect long-term results
Summary
Twenty surgeons were divided into two groups according to their experience in laparoscopic and bariatric surgery. The general group included 10 general surgeons performing between 75 and 100 nonbariatric laparoscopic procedures. The bariatric group included 10 bariatric surgeons performing between 50 and 100 laparoscopic bariatric procedures. We recruited a total of 20 surgeons and divided them into 2 groups on the basis of their experience in laparoscopic and bariatric surgery. The first group, the bariatric group, included 10 surgeons (mean age 36.7 ± 3.3 years) performing between 50 and 100 laparoscopic bariatric procedures (laparoscopic sleeve gastrectomy, LRYGBP, and adjustable gastric banding) and trained in a dedicated center for bariatric surgery. The second group, the general group, included 10 general surgeons (mean age 37.7 ± 5.8 years) performing from 75 to 100 nonbariatric laparoscopic procedures (cholecystectomy, appendectomy, inguinal and incisional hernia repair, and colectomy)
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