No abstract

Three standardized laparoscopic drills have been tested in 150 trainees and demonstrate the incremental acquisition of skills that correlate with improved performance in a challenging and complex laparoscopic skill, intracorporeal suturing.

Background: Laparoscopic surgery adapts poorly to apprenticeship models for general surgical training. Standardized skill acquisition and validation programs, targeted performance goals, and a supervised, enforced, skill-based curriculum that readily can be shared between trainee and instructor must replace the observation and incremental skill-acquisition model used in an open surgical environment. The Yale Laparoscopic Skills and Suturing Program was used to develop a data bank for objective evaluation of dexterity and suturing skills for laparoscopic surgical training. The current study compares trainee and senior surgeon performance in this standardized training program. Objective: To compare objectively evaluated laparoscopic surgical skills and suturing capability of senior surgeons and of residents after they have completed the same standardized training regimen. Methods: Two hundred ninety-one trained surgeons performed 8730 standardized laparoscopic dexterity drills and 2910 intracorporeal suturing exercises in the Yale Laparoscopic Skills and Suturing Program. Their performance was supervised by an instructor who recorded performance and timing of the tasks in a 2 1 ⁄2-day program. Ninety-nine residents performed the same drills and exercises the same number of times and followed the same technique for intracorporeal suturing. Percentile graphs were prepared for each type of drill and suturing exercise to allow comparison of levels of achievement among different training groups. Results: The performance of the residents was the same as that of trained surgeons for the rope pass drill and the suturing exercise. Residents in comparison with trained surgeons performed the triangle transfer drill faster and the new cup drop drill and old cup drop drill more slowly. There was no significant difference in performance between male and female residents. Conclusion: Basic skills relevant to laparoscopic performance can be acquired with a high level of competence in a brief course unrelated to prior surgical experience, sex, or age.

Background:Drones have the ability to gather real time data cost effectively, to deliver payloads and have initiated the rapid evolution of many industrial, commercial, and recreational applications. Unfortunately, there has been a slower expansion in the field of medicine. This article provides a comprehensive review of current and future drone applications in medicine, in hopes of empowering and inspiring more aggressive investigation.Database:A literature search was performed by EBSCO (Elton B. Stephens Company) Discovery Service, searching the phrases “drones,” “UAV,” “unmanned aerial vehicles,” “UAS,” and “unmanned aerial systems.” A second search was used to identify sources that contained “drone” in the subject or title and “medicine” in any of the text, yielding 60,260 results. After screening for irrelevant material, 1296 sources remained applicable. Major themes and number of sources were as follows: 116 public health and medical surveillance, 8 telemedicine, and 78 medical transport systems.Conclusion:Drones are used for surveillance of disaster sites and areas with biological hazards, as well as in epidemiology for research and tracking disease spread. Telecommunication drones are being used for diagnosis and treatment, perioperative evaluation, and telementoring in remote areas. Drones have the potential to be reliable medical delivery platforms for microbiological and laboratory samples, pharmaceuticals, vaccines, emergency medical equipment, and patient transport. Government agencies have placed drone use on the national agenda. The next steps include aggressive research initiatives in the areas of safety, industry expansion, increased public awareness, and participation.

Structured training can be useful for the development of laparoscopic skills. MIST-VR is a valuable part of this training, particularly in the objective evaluation of performance.