Abstract
Laparoscopic surgery is unique and complex in nature, so the training is necessary before proceeding to operation room. Many computer aided simulators have been developed for the purpose. Our objective is to assess the improvement of basic laparoscopic skills after training in simulator. The fifth year medical students underwent training of three laparoscopic skills using Promis2 simulator twice weekly for 4-6 weeks. The skills are laparoscopic orientation, target pointing and objects transferring. Time, path length of instruments and economy of movements were recorded. The comparisons were made for these parameters between session first and the last using a Mann-Whitney U test. Ten volunteers completed the exercises in less time (186.3 +/- 55.4 seconds) than the first exercise (215.7 +/- 57.4 seconds) (P=0.0027). Both the right and left hand instrument path lengths were also improved from 4425.8 +/- 1284.3 mm in the first exercise to 3925.3 +/- 1313.6 mm in the last exercise in the left side (P=0.0219) and likewise from 4273.8 +/- 1859.4 mm to 3831.3 +/- 1717.4 mm in the right side (P=0.0027). Economy of the movement in the left handed instrument improved from 1114.4 +/- 453.5 mm in the first exercise to 966.8 +/- 411.1 mm in the last (P=0.0443) and in the right handed instrument from 845 +/- 398.8 mm to 771.4 +/- 370.5 mm according to the software of Promis2 simulator (P >0.005). Training in Promis2 simulator improves the basic laparoscopic skills. The candidates become consistently faster with shorter path lengths and had smoother instruments movements. They also became significantly more consistent in their performance.
Highlights
Laparoscopic surgery is unique and complex in nature, so the training is necessary before proceeding to operation room
Cadaver training is tried in some parts of the world but lacks bleeding, tissues get tougher as time passes, preservation is expensive and this is not practical in this part of the world.[3]
Economy of the movement in the left handed instrument improved from 1114.4±453.5 mm in the first exercise to 960.8±411.1mm in the last (p-value:0.0443) and in the right handed instrument from 845±398.8mm to 771.4±370.5mm according to the software of Promis[2] simulator (P>0.005) (Table 1)
Summary
Laparoscopic surgery is unique and complex in nature, so the training is necessary before proceeding to operation room. Our objective is to assess the improvement of basic laparoscopic skills after training in simulator. Hand and eye coordination and use of long instruments through the fixed points are necessary skills in laparoscopy surgery. Practice on patients is no longer considered acceptable.[1,2] Animal laboratories are costly because it needs separate infrastructures, instruments and disposal problem. Cadaver training is tried in some parts of the world but lacks bleeding, tissues get tougher as time passes, preservation is expensive and this is not practical in this part of the world.[3]. Simulators have been successfully practiced in flight training, astronauts, war environments and driving before going to actual fields.[4,5,6] It allows mistakes
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
