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A randomised comparative study evaluating learning curves of novices in a basic single-incision laparoscopic surgery
Mikael Sodergren1, Colleen McGregor, Hugo A Farne
1Academic Surgical Unit, Department of Surgery, Division of Surgery and Cancer, Imperial College London, 10th Floor QEQM, St. Mary's Hospital, South Wharf Rd, Paddington, London, UK, W2 1NY. m.sodergren@imperial.ac.uk
Summary
Novice surgeons learning single-incision laparoscopic surgery (SILS) do not achieve the same proficiency as with conventional laparoscopy. Instrument type and prior laparoscopic training do not impact SILS learning curves or skill acquisition.
Area of Science:
- Surgical Education
- Minimally Invasive Surgery
- Surgical Skill Acquisition
Background:
- Objective quantification of novice surgeon learning curves in single-incision laparoscopic surgery (SILS) is lacking.
- Understanding performance changes is crucial for optimizing surgical training and patient outcomes.
Purpose of the Study:
- To evaluate differences in learning rates and proficiency levels between conventional laparoscopy, SILS with straight instruments, and SILS with articulating instruments.
- To determine if prior conventional laparoscopy training influences SILS learning or proficiency.
Main Methods:
- Thirty-six surgically naive medical students performed a validated peg transfer task over 50 repetitions.
- Participants were randomized into groups using conventional laparoscopy, SILS with straight instruments, SILS with articulating instruments, or SILS after conventional laparoscopy training.
Main Results:
- A significant increase in overall proficiency was observed in the conventional laparoscopy group compared to all other groups (p < 0.01).
- No significant differences were found in the rate of learning or ultimate proficiency levels between SILS with straight versus articulating instruments.
- Prior conventional laparoscopy training did not confer an advantage in SILS proficiency or learning rate.
Conclusions:
- Novice surgeons achieve lower proficiency in SILS compared to conventional laparoscopy for basic tasks.
- The choice of straight or articulating instruments and prior laparoscopic training do not significantly affect learning or proficiency in SILS for novice surgeons.