Time trial of dry box laparoscopic surgical training improves laparoscopic surgical skills and surgical outcomes.

Abstract

The present study assessed the utility of a dry box time trial during laparoscopic surgical training to improve laparoscopic surgical skills and surgical outcomes. In a monthly time trial, surgeon trainees twice completed a set task that involved grasping a suture, aligning a needle with a needle holder, passing the suture, making three knots, and cutting the two tails of the suture. The mean suturing time was then analyzed. To assess the utility of this time trial, we analyzed the short-term outcomes of patients with stage I to III colon cancer who had undergone laparoscopic colectomy before and after the introduction of the time trial. The monthly time trial was introduced in October 2018, and 52 surgeon trainees participated in the trials examined in this study. Within 6months of the program's introduction, the mean suturing time had significantly declined to less than 70% of the time trial, while the standard deviations had declined to less than 30%. In comparisons of the short-term outcomes of laparoscopic colon cancer surgery before (n=49) and after (n=46) the introduction of the time trial, the operative time tended to decline (P=.074) after the introduction of the time trial, and blood loss was significantly reduced (P=.018). The rate of postoperative complications was similar before and after the introduction. Regular time trials of laparoscopic surgical suture training using a dry box can be useful for improving laparoscopic surgical skills and surgical outcomes. Moreover, time trials can keep trainees motivated.