A progressive extended protocol for the basic laparoscopic training using the pelvitrainer

Abstract Purpose: We describe an extended training program using the pelvitrainer to improve the basic laparoscopic skills of the junior urologists.

Ten junior residents were involved in our program that consisted of an hour of training every other day; every 3 hours represented one training session. This curriculum started with 4 inanimate tasks that included peg transfer, disc cutout, extracorporeal, and intracorporeal knot tying. Each task was practiced for one training session with an objective evaluation at the initial attempt and at the end of its session. Thereafter, the participants began to perform an anastomosis using a latex glove model of the laparoscopic urethrovesical anastmosis (L-UVA) (5 experiments). This was followed by 10 experiments of the sheep intestine model of the L-UVA. The performance in these models was evaluated by both the amount of leakage of the injected saline and the time required for completing it. Lastly, another sheep intestine model was performed 3 weeks after the end of the training program.

The continuous evaluation of these trainees showed that there was a significant decrease in the time required to perform each of the first 4 tasks at the end of their corresponding sessions compared to the base line values (p=0.000). We also detected a significant decrease in the time and the amount of leakage in sheep intestine models in the 10th attempt compared to the first one (p=0.000). However, there was no significant difference between the results at the 10th model and those of the 3 weeks retest regarding both the time (p=0.198) and the amount of leakage (p=0.076).

The use of the two described models of the L-UVA after the inanimate tasks in the pelvitrainer distributed course of training could help in the improvement and in the retention of the basic laparoscopic skills of the junior urologists.