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Training Laparoscopic Surgeons: Assessing Workload and Skill Using Nasa-Tlx.

Muhammed Salih Süer1, Serkan Demir1, Mehmet Hanifi Çanakçı1

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Summary

Surgical residents experience reduced workload and improved laparoscopic suturing skills with increased training experience. Early exposure and simulation-based training are key to enhancing proficiency and patient safety.

Keywords:
LaparoscopySurgical educationSuturingTask performance and analysisWorkload

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Area of Science:

  • Surgical Education
  • Minimally Invasive Surgery
  • Medical Simulation

Background:

  • Laparoscopic suturing is a complex skill in minimally invasive surgery.
  • Subjective workload and objective performance in laparoscopic suturing are not well-studied.
  • Simulation-based training is increasingly emphasized for surgical skills acquisition.

Purpose of the Study:

  • To investigate the subjective workload and objective performance in laparoscopic suturing among general surgery residents.
  • To explore the correlation between residents' training level, case volume, and suturing proficiency.
  • To identify factors influencing workload and performance in laparoscopic suturing.

Main Methods:

  • Prospective study involving 68 general surgery residents performing a standardized box-trainer laparoscopic suturing task.
  • Subjective workload assessed using the NASA Task Load Index (NASA-TLX).
  • Objective performance evaluated with a novel Suture Point System measuring accuracy, tension control, and speed.

Main Results:

  • A significant learning curve was observed, with junior residents (PGY-1/2) reporting higher workload (mean NASA-TLX 72.38 for PGY-1) and lower proficiency than senior residents (mean NASA-TLX 23.33 for PGY-5).
  • Higher laparoscopic case volume correlated with improved suture scores and reduced perceived mental and physical demands.
  • No statistically significant differences in proficiency or workload were found based on sex.

Conclusions:

  • Early and targeted laparoscopic suturing practice within a structured curriculum is crucial.
  • Simulation-based training with standardized feedback and ergonomic design can accelerate skill acquisition and reduce novice frustration.
  • Integrating workload assessment tools can identify trainees needing intervention, enhancing training efficiency and patient safety.