A standardized simulation training program to type 1 loop electrosurgical excision of the transformation zone: a...

Area of Science:

• Gynecology
• Surgical Education
• Medical Simulation

Background:

• Loop electrosurgical excision procedure (LEEP) is a common gynecological procedure.
• Accurate cone length is critical to avoid complications.
• Standardized training programs are needed to ensure proficiency.

Purpose of the Study:

• To evaluate a simulation-based training program for type 1 LEEP.
• To assess the effectiveness of low-fidelity simulation for postgraduate surgical training.

Main Methods:

• Seventeen surgeons (12 novice, 5 experienced) performed 170 simulated type 1 LEEP procedures.
• Procedures were performed on a low-fidelity simulator under colposcopic vision.
• Key outcome measures included cone length, specimen fragmentation, and a LEEP score.

Main Results:

• Novice surgeons showed significant improvement in excision precision after five simulated procedures (p=0.023).
• Experienced surgeons maintained consistently high performance.
• Inexperienced surgeons were more likely to perform excessively deep cuts (27.5% vs. 8%, p=0.003).

Conclusions:

• Low-fidelity simulation training effectively teaches accurate cone length for type 1 LEEP to novice surgeons.
• Simulation training is recommended before performing LEEP on women of reproductive age due to risks of premature delivery from excessive excisions.