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Emergency Undocking in Robotic Surgery: A Simulation Curriculum
Published on: May 20, 2018
Contribution of simulation in paediatric laparoscopic surgery: improving suturing skills before performing a
Valeska Bidault-Jourdainne1,2,3, Jean Breaud4, Liza Ali5,6
1Urovisceral Paediatric Surgery Department, HFME, Civil Hospices of Lyon, Lyon, France. valeska.bidault@chu-lyon.fr.
Introduction:
Mastering paediatric laparoscopic surgery competency (PLSC) is technically challenging. The present study aimed to determine whether the inter-academic PLSC degree (IAD_PLSC) practical training program enables trainees to improve their skills.
Methods:
This retrospective study included trainees enrolled in the IAD_PLSC program in 2021 and 2022 which included two separate 12 h-sessions. Trainees practiced to perform intracorporeal laparoscopic knots (ILK) using 5- and 3-mm instruments on a pelvi-trainer simulator; Peg Transfer (PT) was used as a dexterity test; final marks added the adapted Objective Structured Assessment of Technical Skills (OSATS) score (out of 40) and time to complete ILK. ILK was considered a success in case the OSATS score > 27/40.
Results:
A total of 43 trainees completed the IAD_PLSC program. N = 37 (86.0%) mastered the ILK (OSATS score > 27/40) using 5-mm instruments at the end of session 1 and N = 33 (76.7%) at the end of session 2 (p = 0.41). There was no significant improvement in the median [interquartile range, IQR] OSATS score (32 [30-36] vs. 32 [28-34], p = 0.19), but the median [IQR] knot completion time improved significantly (184 s [161-268] vs. 166 s [128-218], p = 0.002). There was a significant correlation between the knot completion time and PT time at the end of session 1 (ρ = 0.58, 95% confidence interval, CI [0.31;0.76], p < 0.0002) and session 2 (ρ = 0.78, 95%CI [0.62;0.87], p < 0.0001). When using 3-mm instruments, N = 34 (79.1%) of trainees mastered the ILK at the end of session 2. The median [IQR] OSATS score significantly improved between the end of the two sessions (22 [21-24] vs. 31 [28-33], p < 0.0001), but there was no significant correlation between OSATS score or knot completion time and PT time, at the end of both sessions.
Conclusion:
A nation-wide training program in paediatric laparoscopic surgery provides valuable practical training of intracorporeal suturing for residents in pediatric surgery and urology.
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