Simulation platforms to assess laparoscopic suturing skills: a scoping review

Area of Science:

• Surgical Education
• Medical Simulation
• Minimally Invasive Surgery

Background:

• Laparoscopic suturing (LS) is a critical skill in advanced laparoscopic procedures.
• Many surgical trainees struggle to achieve proficiency in LS by the end of their training.
• Assessing LS competence is crucial for patient safety and surgical outcomes.

Purpose of the Study:

• To identify and characterize simulation platforms for assessing laparoscopic suturing skills.
• To determine the specific LS skills targeted by existing simulation platforms.
• To evaluate the current state of LS skills assessment in surgical training.

Main Methods:

• A comprehensive scoping review of full-text articles published between January 1997 and October 2018.
• Searches conducted across multiple databases using terms like "laparoscopic suturing" and "clinical competence."
• Inclusion of English and French articles, with additional studies identified via reference lists.

Main Results:

• Sixty-two studies were included in the review.
• Most simulation platforms utilized box trainers with inanimate tissue, focusing on basic suturing and intracorporeal knot-tying.
• Validation primarily relied on internal structure (rater reliability) and comparisons with training levels/experience; consequences were not assessed.

Conclusions:

• A variety of simulation platforms exist for assessing basic LS skills.
• Platforms for evaluating advanced LS skills competence are limited.
• Future research should prioritize developing LS simulation tasks that better align with trainee needs and advanced surgical requirements.