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Improving operative performance using a laparoscopic hernia simulator.

E C Hamilton1, D J Scott, A Kapoor

  • 1Southwestern Center for Minimally Invasive Surgery, Department of Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9092, USA.

American Journal of Surgery
|February 13, 2002
PubMed
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A new laparoscopic training curriculum significantly improved surgical residents' understanding and performance of total extraperitoneal (TEP) hernia repairs. This training enhanced residents' comfort and willingness to perform the TEP hernia procedure.

Area of Science:

  • Minimally Invasive Surgery
  • Surgical Education
  • Medical Simulation

Background:

  • Traditional surgical skill acquisition occurs in the operating room.
  • Novel ex-vivo training methods are emerging due to cost and patient safety challenges.
  • Evaluating new training curricula is essential for surgical education.

Purpose of the Study:

  • To assess the impact of a laparoscopic training curriculum on surgical residents' operative performance.
  • To determine if a multimodality approach enhances TEP hernia repair skills.
  • To evaluate resident confidence and understanding post-training.

Main Methods:

  • Twenty-one residents performed baseline laparoscopic total extraperitoneal (TEP) hernia repairs.
  • Residents were randomized into control and training groups.

Related Experiment Videos

  • The training group utilized a CD ROM, video, and simulator.

    • Main Results:

    • The trained group showed significantly greater improvement in 5 of 8 global assessment areas and the composite score (P <0.05).
    • Training improved understanding of TEP hernia repair (P = 0.01).
    • Residents demonstrated increased willingness to perform TEP hernia repairs (P = 0.02).

    Conclusions:

    • A multimodality laparoscopic TEP hernia curriculum enhances resident knowledge and comfort.
    • The curriculum may lead to improved operative performance in TEP hernia repair.
    • Ex-vivo training offers a viable method for improving surgical skills.