Effect of three training programs on surgical performance in single-port laparoscopic surgery

Area of Science:

• Surgical Education
• Minimally Invasive Surgery
• Medical Simulation

Background:

• Laparoendoscopic single-site surgery (LESS) presents unique challenges for surgeons.
• Acquiring psychomotor skills for LESS is crucial for patient safety and surgical outcomes.
• Traditional laparoscopic training may not fully translate to the demands of LESS.

Purpose of the Study:

• To compare the effectiveness of three distinct training methodologies for psychomotor skill acquisition in LESS.
• To evaluate the impact of straight versus articulating instruments in LESS training.
• To assess skill acquisition using motion analysis parameters (MAPs) in a simulated environment.

Main Methods:

• A prospective study involving three groups of participants undergoing 12 days of simulator-based training.
• Group A: Conventional laparoscopy with straight instruments, plus LESS with straight and articulating instruments.
• Group B: LESS with straight and articulating instruments.
• Group C: LESS with articulating instruments only.
• Performance was quantified using a video-tracking system and 12 MAPs.

Main Results:

• All training groups demonstrated significant improvements across most MAPs.
• Group C (LESS with articulating instruments) showed enhanced technical competence, improving in nine MAPs.
• Group A exhibited notable improvements in bimanual dexterity.

Conclusions:

• Training specifically for LESS using articulating instruments enhances surgical skill quality.
• Articulating instruments in LESS training facilitate a more efficient learning curve.
• Simulation-based training with advanced instruments is effective for LESS skill development.