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Use of box simulators for improving intraoperative laparoscopic skills - an essential tool for the surgeon in
Awais Amjad Malik1, Mahmood Ayyaz1, Muhammad Farooq Afzal1
1Department of General Surgery, Services Institute of Medical Sciences, Services Hospital, Lahore.
Objective:
To compare the improvement of intraoperative laparoscopic skills by measuring GOALS score between residents who have undergone simulator training with those who have not received any simulator training.
Study Design:
A randomized controlled trial.
Place And Duration Of Study:
Department of Surgery, Services Hospital, Lahore, from August 2013 to February 2014.
Methodology:
Thirty residents belonging to year 1, 2 and 3 were included in the study. They were randomly divided into 2 groups. Both groups had a baseline evaluation with GOALS score while performing dissection of gallbladder from liver bed during laparoscopic cholecystectomy. Group-A underwent formal training on simulators whereas group-B did not receive any formal training on simulators. After 6 months, a repeat evaluation was done again by measuring GOALS score while performing gallbladder dissection.
Results:
Baseline GOALS scores of both the groups were similar. Group-A baseline score was 7.66 ± 0.93 and group-B score was 7.46 ± 1.04 (p = 0.585). However repeat scores for group-A showed a significant improvement (an increase of 7.16 ± 1.48 to 14.76 ± 1.67, p < 0.001) from baseline scores. Residents in group-B improved their scores by 2.30 ± 0.99 to 9.76 ± 0.79 (p < 0.001). When inter group comparison was done the second score of group-A was significantly higher than that of group-B (14.76 ± 1.67 vs. 9.76 ± 0.79, p < 0.001). Inter-rater reliability was moderately significant (Kappa 0.540).
