Improving operative performance using a laparoscopic hernia simulator.

E C Hamilton; D J Scott; A Kapoor; F Nwariaku; P C Bergen; R V Rege; S T Tesfay; D B Jones

doi:10.1016/s0002-9610(01)00800-5

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Improving operative performance using a laparoscopic hernia simulator.

E C Hamilton·D J Scott·A Kapoor·F Nwariaku·P C Bergen·R V Rege·S T Tesfay·D B Jones

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Abstract

BACKGROUND: Traditionally, the acquisition of surgical skill has occurred entirely in the operating room. To meet the expanding challenges of cost containment and patient safety, novel methods of surgical training utilizing ex-vivo workstations are being developed. The purpose of our study was to evaluate the impact of a laparoscopic training curriculum on surgical residents' operative performance. METHODS: Twenty-one surgery residents completed baseline laparoscopic total extraperitoneal (TEP) hernia repairs. Operative performance was evaluated using a validated global assessment tool. Each resident was then randomized to a control group or a trained group. A CD ROM, video, and simulator were used for training. At the end of the study, each resident's operative performance was again evaluated. RESULTS: Improvement was significantly greater in the trained group in five of the eight individual global assessment areas as well as the composite score (P <0.05). Questionnaire data suggested that training resulted in improved understanding of the TEP hernia repair (P = 0.01) and an increased willingness to offer the operation to patients with nonrecurrent unilateral hernias (P = 0.02). CONCLUSIONS: A multimodality laparoscopic TEP hernia curriculum improves residents' knowledge of the TEP hernia repair and comfort in performing the procedure, and may also improve actual operative performance.

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Clinical Competence Curriculum Educational Measurement General Surgery Hernia, Inguinal Humans Internship and Residency Laparoscopy Models, Anatomic Clinical Trial Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

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E C Hamilton, D J Scott, A Kapoor, F Nwariaku, P C Bergen, R V Rege, S T Tesfay, D B Jones. 2001. Improving operative performance using a laparoscopic hernia simulator.. https://doi.org/10.1016/s0002-9610(01)00800-5

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