Effect of visual feedback during laparoscopic basic training using a box trainer with a transparent top.

Kosei Maemura,Hiroshi Kurahara,Shinichirou Mori,Masahiko Sakoda,Shoji Natsugoe,Satoshi Iino,Yota Kawasaki,Shinichi Ueno,Yuko Mataki,Hiroyuki Shinchi

doi:10.1002/ags3.12010

Abstract

Laparoscopic surgical training using a box trainer facilitates mastery of laparoscopic surgery. Few studies have investigated whether visualizing the surgical field in the box trainer improves performance of laparoscopic surgical procedures during laparoscopic training. An original box trainer equipped with a transparent top made of mesh covered with a latticed structure was developed and used for evaluation of novices during laparoscopic training. Three tasks (levels 1 to 3) involving organ handling while setting the surgical field were arranged to evaluate the efficacy of training. Forty‐five students were divided into three groups: group A, students without practical training; group B, students trained using the covered box trainer; and group C, students trained using the transparent box trainer. Completion time of each task before and after training was compared. Training significantly reduced the operating time, with a significant difference between the level 1 task and the levels 2 (P<.001) and 3 (P<.0001) tasks. There was no significant difference in operating time between the levels 2 and 3 tasks. Overall time reduction rate in group C was significantly shorter than that in group A, but not in group B. The time reduction rate for the level 3 task was lowest in group C, with a statistically significant difference existing in group A (P<.001). Visual feedback during surgery through the transparent top of the laparoscopic box trainer helped reduce the learning time required to carry out laparoscopic surgery.

Highlights

Laparoscopic surgery is one of the fastest growing areas in surgery and has become an important choice for most surgical treatment.[1,2,3,4] Surgical training to acquire technical skills and ensure patient safety is well known to be beneficial in nonclinical settings.[5,6,7,8] naive operators have some difficulties in learning to carry out and manage laparoscopic surgical procedures
The primary goal of the present study was to verify whether laparoscopic training with real-time visual feedback through a transparent view is useful to master laparoscopic surgical organ handling for novices
Group C consisted of students with practical training using the transparent box trainer that allows for visualization of the inside of the box during the training

Summary

Introduction

Laparoscopic surgery is one of the fastest growing areas in surgery and has become an important choice for most surgical treatment.[1,2,3,4] Surgical training to acquire technical skills and ensure patient safety is well known to be beneficial in nonclinical settings.[5,6,7,8] naive operators have some difficulties in learning to carry out and manage laparoscopic surgical procedures. Novice surgeons need to overcome the lack of stereopsis, restricted haptic feedback, difficult handling of unfamiliar instruments with the fulcrum effect, and looking over the working space.[5,9]. The training simulator for laparoscopic surgery is generally classified into two categories: the classical box trainer and the computer simulator. The box trainer is made of common materials

Objectives

Methods

Results