Laparoscopic suturing learning curve in an open versus closed box trainer
Identifieur interne : 003907 ( Ncbi/Checkpoint ); précédent : 003906; suivant : 003908Laparoscopic suturing learning curve in an open versus closed box trainer
Auteurs : S. P. Rodrigues [Pays-Bas] ; T. Horeman [Pays-Bas] ; M. S. H. Blomjous [Pays-Bas] ; E. Hiemstra [Pays-Bas] ; J. J. Van Den Dobbelsteen [Pays-Bas] ; F. W. Jansen [Pays-Bas]Source :
- Surgical Endoscopy [ 0930-2794 ] ; 2015.
Abstract
The aim of this study was to examine the influence of training under direct vision prior to training with indirect vision on the learning curve of the laparoscopic suture task.
Novices were randomized in two groups. Group 1 performed three suturing tasks in a transparent laparoscopic box trainer under direct vision followed by three suturing tasks in a standard non-transparent laparoscopic box trainer equipped with a 0° laparoscope. Group 2 performed six suturing tasks in a standard laparoscopic box trainer. Performance time, motion analysis parameters (economy of movements) and interaction force parameters (tissue handling) were measured. Participants completed a questionnaire assessing: self-perceived dexterity before and after the training, their experienced frustration and the difficulty of the training.
A total of 34 participants were included, one was excluded because of incomplete training. Group 1 used significantly less time to complete the total of six tasks (27 %). At the end of the training, there were no differences in motion or force parameters between the two groups. Group 2 rated their self-perceived dexterity after the training significantly lower than before the training and also reported significantly higher levels of frustration compared to group 1. Both groups rated the difficulty of the training similar.
Novices benefit from starting their training of difficult basic laparoscopic skills, e.g., suturing, in a transparent box trainer without camera. It takes less time to complete the tasks, and they get less frustrated by the training with the same results on their economy of movements and tissue handling skills.
Url:
DOI: 10.1007/s00464-015-4211-0
PubMed: 25939742
PubMed Central: 4710670
Affiliations:
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Horeman</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Department of BioMechanical Engineering, Delft University of Technology, Delft, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of BioMechanical Engineering, Delft University of Technology, Delft</wicri:regionArea><wicri:noRegion>Delft</wicri:noRegion></affiliation></author><author><name sortKey="Blomjous, M S H" sort="Blomjous, M S H" uniqKey="Blomjous M" first="M. S. H." last="Blomjous">M. S. H. 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Hiemstra</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Gynecology, K6-76, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Gynecology, K6-76, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden</wicri:regionArea><wicri:noRegion>2300 RC Leiden</wicri:noRegion></affiliation></author><author><name sortKey="Van Den Dobbelsteen, J J" sort="Van Den Dobbelsteen, J J" uniqKey="Van Den Dobbelsteen J" first="J. J." last="Van Den Dobbelsteen">J. J. 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P." last="Rodrigues">S. P. Rodrigues</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Gynecology, K6-76, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Gynecology, K6-76, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden</wicri:regionArea><wicri:noRegion>2300 RC Leiden</wicri:noRegion></affiliation></author><author><name sortKey="Horeman, T" sort="Horeman, T" uniqKey="Horeman T" first="T." last="Horeman">T. Horeman</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Department of BioMechanical Engineering, Delft University of Technology, Delft, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of BioMechanical Engineering, Delft University of Technology, Delft</wicri:regionArea><wicri:noRegion>Delft</wicri:noRegion></affiliation></author><author><name sortKey="Blomjous, M S H" sort="Blomjous, M S H" uniqKey="Blomjous M" first="M. S. H." last="Blomjous">M. S. H. Blomjous</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Gynecology, K6-76, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Gynecology, K6-76, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden</wicri:regionArea><wicri:noRegion>2300 RC Leiden</wicri:noRegion></affiliation></author><author><name sortKey="Hiemstra, E" sort="Hiemstra, E" uniqKey="Hiemstra E" first="E." last="Hiemstra">E. Hiemstra</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Gynecology, K6-76, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Gynecology, K6-76, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden</wicri:regionArea><wicri:noRegion>2300 RC Leiden</wicri:noRegion></affiliation></author><author><name sortKey="Van Den Dobbelsteen, J J" sort="Van Den Dobbelsteen, J J" uniqKey="Van Den Dobbelsteen J" first="J. J." last="Van Den Dobbelsteen">J. J. Van Den Dobbelsteen</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Department of BioMechanical Engineering, Delft University of Technology, Delft, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of BioMechanical Engineering, Delft University of Technology, Delft</wicri:regionArea><wicri:noRegion>Delft</wicri:noRegion></affiliation></author><author><name sortKey="Jansen, F W" sort="Jansen, F W" uniqKey="Jansen F" first="F. W." last="Jansen">F. W. Jansen</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Gynecology, K6-76, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Gynecology, K6-76, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden</wicri:regionArea><wicri:noRegion>2300 RC Leiden</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2">Department of BioMechanical Engineering, Delft University of Technology, Delft, The Netherlands</nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of BioMechanical Engineering, Delft University of Technology, Delft</wicri:regionArea><wicri:noRegion>Delft</wicri:noRegion></affiliation></author></analytic><series><title level="j">Surgical Endoscopy</title><idno type="ISSN">0930-2794</idno><idno type="eISSN">1432-2218</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>The aim of this study was to examine the influence of training under direct vision prior to training with indirect vision on the learning curve of the laparoscopic suture task.</p></sec><sec><title>Methods</title><p>Novices were randomized in two groups. Group 1 performed three suturing tasks in a transparent laparoscopic box trainer under direct vision followed by three suturing tasks in a standard non-transparent laparoscopic box trainer equipped with a 0° laparoscope. Group 2 performed six suturing tasks in a standard laparoscopic box trainer. Performance time, motion analysis parameters (economy of movements) and interaction force parameters (tissue handling) were measured. Participants completed a questionnaire assessing: self-perceived dexterity before and after the training, their experienced frustration and the difficulty of the training.</p></sec><sec><title>Results</title><p>A total of 34 participants were included, one was excluded because of incomplete training. Group 1 used significantly less time to complete the total of six tasks (27 %). At the end of the training, there were no differences in motion or force parameters between the two groups. Group 2 rated their self-perceived dexterity after the training significantly lower than before the training and also reported significantly higher levels of frustration compared to group 1. Both groups rated the difficulty of the training similar.</p></sec><sec><title>Conclusion</title><p>Novices benefit from starting their training of difficult basic laparoscopic skills, e.g., suturing, in a transparent box trainer without camera. It takes less time to complete the tasks, and they get less frustrated by the training with the same results on their economy of movements and tissue handling skills.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Aggarwal, R" uniqKey="Aggarwal R">R Aggarwal</name></author><author><name sortKey="Moorthy, K" uniqKey="Moorthy K">K Moorthy</name></author><author><name sortKey="Darzi, A" uniqKey="Darzi A">A Darzi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Seymour, Ne" uniqKey="Seymour N">NE Seymour</name></author><author><name sortKey="Gallagher, Ag" uniqKey="Gallagher A">AG Gallagher</name></author><author><name sortKey="Roman, Sa" uniqKey="Roman S">SA Roman</name></author><author><name sortKey="O Rien, Mk" uniqKey="O Rien M">MK O’Brien</name></author><author><name sortKey="Bansal, Vk" uniqKey="Bansal V">VK Bansal</name></author><author><name sortKey="Andersen, Dk" uniqKey="Andersen 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P." last="Rodrigues">S. P. Rodrigues</name></noRegion><name sortKey="Blomjous, M S H" sort="Blomjous, M S H" uniqKey="Blomjous M" first="M. S. H." last="Blomjous">M. S. H. Blomjous</name><name sortKey="Hiemstra, E" sort="Hiemstra, E" uniqKey="Hiemstra E" first="E." last="Hiemstra">E. Hiemstra</name><name sortKey="Horeman, T" sort="Horeman, T" uniqKey="Horeman T" first="T." last="Horeman">T. Horeman</name><name sortKey="Jansen, F W" sort="Jansen, F W" uniqKey="Jansen F" first="F. W." last="Jansen">F. W. Jansen</name><name sortKey="Jansen, F W" sort="Jansen, F W" uniqKey="Jansen F" first="F. W." last="Jansen">F. W. Jansen</name><name sortKey="Van Den Dobbelsteen, J J" sort="Van Den Dobbelsteen, J J" uniqKey="Van Den Dobbelsteen J" first="J. J." last="Van Den Dobbelsteen">J. J. Van Den Dobbelsteen</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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