Development and Validation of a Homemade, Low-Cost Laparoscopic Simulator for Resident Surgeons (LABOT)

Abstract

Several studies have demonstrated that training with a laparoscopic simulator improves laparoscopic technical skills. We describe how to build a homemade, low-cost laparoscopic training simulator (LABOT) and its validation as a training instrument. First, sixty surgeons filled out a survey characterized by 12 closed-answer questions about realism, ergonomics, and usefulness for surgical training (global scores ranged from 1—very insufficient to 5—very good). The results of the questionnaires showed a mean (±SD) rating score of 4.18 ± 0.65 for all users. Then, 15 students (group S) and 15 residents (group R) completed 3 different tasks (T1, T2, T3), which were repeated twice to evaluate the execution time and the number of users’ procedural errors. For T1, the R group had a lower mean execution time and a lower rate of procedural errors than the S group; for T2, the R and S groups had a similar mean execution time, but the R group had a lower rate of errors; and for T3, the R and S groups had a similar mean execution time and rate of errors. On a second attempt, all the participants tended to improve their results in doing these surgical tasks; nevertheless, after subgroup analysis of the T1 results, the S group had a better improvement of both parameters. Our laparoscopic simulator is simple to build, low-cost, easy to use, and seems to be a suitable resource for improving laparoscopic skills. In the future, further studies should evaluate the potential of this laparoscopic box on long-term surgical training with more complex tasks and simulation attempts.

Early and Standard Urinary Catheter Removal After Gynecological Surgery for Benign Lesions: A Quasi-Experimental Study

“…Two studies regarding the timing of Foley catheter involved patients who had undergone laparotomy (Joshi et al, 2014; Ouladsahebmadarek et al, 2012). However, advances in technology for minimally invasive surgery have made laparoscopic surgery a useful option for patients with benign gynecological tumors, based on smaller wounds, faster postoperative recovery, reduced wound pain, and fewer adhesions, relative to exploratory laparotomy (Chang et al, 2020; Chung et al, 2019; Jiang & Wang, 2019; Soriero et al, 2020). Our findings echo those for patients who underwent laparoscopically assisted vaginal hysterectomy, which found immediate catheter removal increased the urinary retention rate to 14% to 34% (Brackmann et al, 2020; Ghezzi et al, 2007; Liang et al, 2009).…”

Natural Orifice Transluminal Endoscopic Surgery (NOTES): Landscape of Current Experimental Applications in Gynecological Surgery

“…Overall, we would underscore that an appropriate training in NOTES will be a key issue in future education and development of this surgical approach, similarly to that today happens for conventional laparoscopy, for which our research group dedicates an important effort [10]. Nevertheless, new studies on gynecological applications of NOTES are demanding to draw conclusion on the potential clinical indications for which adopting this technique.…”

Role of laparoscopic simulators in the development and assessment of laparoscopic surgical skills in laparoscopic surgery and gynecology (Review)

“…The participants demonstrated the appropriate use of dominant and non-dominant hand with the use of two atraumatic forceps by passing a thread through a ring path, putting five bolts on top of each other and passing a bolt from one hand to the other and putting it in a box. It was concluded that this simple and low-cost laparoscopic box trainer permits improvement of the basic technical laparoscopic skills, particularly at the beginning of the surgical training (117).…”