Laparoscopic training in porcine models: a tool for continuous professional skill enhancement for paediatric surgeons

Laparoscopic training is an established component of minimally invasive surgery education, and involves different tools: virtual reality, training box and in vivo models. The use of porcine models is the most similar to human anatomy. Its role is well known during the residency program, but its specific impact on paediatric surgery consultants performance is poorly explored.

Six consultant surgeons attempted a consecutive 4-h a week laparoscopic training on porcine models for a total of 12 weeks, focusing on refinement of fine dissection, intracorporeal suturing, and management of intraoperative complications. Participants underwent pre- and post-training (respectively Period A and B) assessment of surgical effectiveness by assessment of mean operative time, intraoperative and postoperative complications on three commonly performed procedures: inguinal hernia repair, varicocelectomy and laparoscopic orchiopexy.

210 procedures were analysed, 109 before and 101 after the training. We observed a significant overall reduction in operative time for all procedures (p = 0.007); more precisely, inguinal hernia repair and varicocelectomy showed a significant reduction in operative time (p = 0.028 and p = 0.04 respectively), while no significant reduction in operative time for laparoscopic orchidopexy was observed (p = 0.2668). Mean age at surgical intervention was significantly reduced in period B for herniorrhaphy.

Laparoscopic training in porcine models could be considered an effective tool to improve skills of paediatric surgery consultants. Its use could allow the improvement of laparoscopic confidence and effectiveness also in surgeons with an already acquired learning curve, supporting the systematic and continuous integration of such programmes into the professional development.