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Evidence to support the early introduction of laparoscopic suturing skills into the surgical training curriculum
Benjie Tang1, Lin Zhang2, Afshin Alijani3,4
1Surgical Skills Centre, Dundee Institute for Healthcare Simulation, Ninewells Hospital and Medical School, University of Dundee, Dundee, DD1 9SY, UK. b.tang@dundee.ac.uk.
Background:
The objectives of this study were to investigate the relationship between the acquisition of laparoscopic suturing skills and other operative laparoscopic skills and to provide evidence to determine ideal time and duration to introduce laparoscopic suturing training.
Methods:
The first part of the study explored the relationship between the acquisition of laparoscopic suturing skills and proficiency of other operative laparoscopic skills. The second part of the study consisted of an opinion survey from senior and junior trainees on aspects of training in laparoscopic suturing.
Results:
One hundred twenty-eight surgical trainees participated in this study. The total scores of task performance of 57 senior surgical trainees in laparoscopic suturing skills consisting of needle manipulation and intracoporeal knot tying were improved significantly after the training course (46.9 ± 5.3 vs 29.5 ± 9.4, P < .001), the improvement rate was 59%. No statistically significant correlations were observed between intracorporeal laparoscopic suturing skills and proficiency in the basic laparoscopic manipulative skills assessed before (r = 0.193; P = 0.149) and after (r = 0.024; P = 0.857) the training course. 91% of senior trainees and 94% junior trainees expressed that intracorporeal suturing should be introduced at an early stage of the training curriculum.
Conclusions:
There was no statistically significant correlation between the performance on basic operative laparoscopic skills (non-suturing skills) and laparoscopic suturing skills observed in this study. The acquisition of basic laparoscopic skills is not a prerequisite for training in intracorporeal suturing and it may be beneficial for the surgical trainees to learn this skill early in the surgical training curriculum. Surgical trainees want to learn and practice laparoscopic suturing earlier than later in their training.
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