Simulation as tool for evaluating and improving technical skills in laparoscopic gynecological surgery

Mannella, Paolo; Malacarne, Elisa; Giannini, Andrea; Russo, Eleonora; Caretto, Marta; Papini, Francesca; Guevara, Maria Magdalena Montt; Pancetti, Federica

doi:10.1186/s12893-019-0610-9

Cited by 17 publications

(37 citation statements)

References 23 publications

(24 reference statements)

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“…The teaching of surgical techniques and surgery simulation gave rise to the need for mechanisms to evaluate the procedure, and OSATS has been widely used in several surgical areas for skill evaluation 20 , 24 including thoracic surgery 17 . The global rating scale used in the present study, adapted from the OSATS, demonstrated an improvement in continuous assessment from steps 1 to 3, but only the scores assigned by examiner 2 were statistically different.…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a simulator for teaching minimally invasive thoracic surgery in Brazil

et al. 2021

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Purpose To develop and validate a chest cavity simulator for teaching video-assited thoracic surgery (VATS). Methods The first phase of the study consisted of developing a chest cavity simulator. A quasi-experimental study was performed in the second phase, and 25 surgeons and residents participated in a three-stage pulmonary suture experiment. The videos were recorded and timed. Generalized linear regression models for repeated measures were used to analyze the outcome change over time. Results The chest cavity simulator consists of a console simulating the left hemithorax. Among the participants, 96% rated the design, visual aspect, positioning ergonomics, and triangulation of the portals as very good or excellent (face validity). There was a decrease in suturing time in step 1 from 435.7 ± 105 to 355.6 ± 76.8 seconds compared to step 3 (p = 0.001). The evaluation of the simulation effectiveness and performance (content validity) was rated as very good or excellent by 96% ofparticipants. The most experienced surgeon showed significant reduction in procedure time (p = 0.021) (construct validity). Conclusions The thoracic cavity simulator is realistic, showing content and construct validity, and can be used in VATS training. The simulation model allowed skill gain in the endoscopic suture.

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Section: Discussionmentioning

confidence: 99%

Development and validation of a simulator for teaching minimally invasive thoracic surgery in Brazil

et al. 2021

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“…[ 4 ] Simulation is a powerful tool to improve own capacities for laparoscopy skills. [ 11 ] Postgraduates need opportunities for regular, deliberate practice on simulators under faculty guide with constructive developmental feedback. [ 12 ] The apprentice-tutor model of surgical training “see one, do one, teach one” has lost favor to a variety of simulation methods that, while improving the skills of trainee, has zero risk to patient.…”

Section: Discussionmentioning

confidence: 99%

Simulation-based structured training for developing laparoscopy skills in general surgery and obstetrics & gynecology postgraduates

Charokar¹,

Modi

2021

Journal of Education and Health Promotion

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BACKGROUND: Simulation-based training is an important strategy for skill development in a competency-based curriculum, especially so for laparoscopic surgery given its unique learning curve, need for practice, and patient safety concerns. The study was conducted for postgraduates in two surgical disciplines in a medical college tertiary care center. The study evaluates the acceptability and utility of structured simulation-based training for laparoscopic skills. Simulations provide deliberate practice in the leaner supportive environment. MATERIALSAND METHODS: The educational intervention was carried out among the 16 postgraduates from year 2 and year 3 of general surgery and obstetrics and gynecology. A structured training and assessment module was designed and validated, and a 12-week structured training on laparoscopic box trainers was given to postgraduates under faculty guidance. Feedback from postgraduates and faculty was obtained using separate validated questionnaires. The pre- and post-training assessment scores were compared applying the Wilcoxon matched-pairs signed-rank (2-tailed) test using the SPSS Windows Version 20.0 (IBM Corporation). RESULTS: Sixteen postgraduates participated in the study. The median satisfaction score of the postgraduates was 4 (range 3–5), a scale of a maximum of 5. The group identified faculty feedback, stepwise skills learning, supportive learning environment, and trainers’ motivation as enabling factors in the training. The faculty observed that the trainees were effectively engaged. The group mean improvement scores in percentage were 40.08 for task 1, 42.08 for task 2, 43.13 for task 3, and 45.63 for task 4. CONCLUSIONS: It is feasible to incorporate faculty-guided sessions of simulation training in basic laparoscopy skills for postgraduates in our setup. It is well accepted by the key stakeholders, and we recommend it to be incorporated in the formal training program.

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“…Our results and evidence found in the literature suggest that simulator based educational programs should be an adjunct in the curriculum of minimal-invasive surgery training. Although most available data on this subject occur from visceral surgery and gynecology (18), we believe that they hold true in thoracic surgery. Over a very short training period, our impression was that resident 3D orientation, hand coordination and trainee satisfaction improved.…”

Section: Integration In the Standard Cursus And Library For Preparati...mentioning

confidence: 92%

Learning of VATS right lower lobe anterior-basal segmentectomy (S8) on a 3D printed simulator

Koliakos¹,

Pál²,

González³

et al. 2022

J Vis Surg

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Background: Thoracic Surgery has dramatically evolved over the past 15 years with a switch in practice from exclusively open to a majority of minimal invasive approaches for the management of non-small cell lung cancer but also metastasis. For these indications, segmentectomies have become more popular and have made an important comeback in the field. The current practice therefore represents a challenge in the capacity of trained surgeons to teach these technically demanding surgeries to trainees in a safe way.Here, we report our experience with 3D printed lung model simulators for the teaching of right lower lobe anterior-basal segmentectomy (S8).Methods: We used 3D silicone printed lungs with an anatomy showing bronchis, veins and arteries up to the segmental level. With a weekly training protocol consisting of two residents supervised by a fellow and a staff surgeon, we worked the practical approach of minimal invasive right lower lobe anterior-basal segmentectomy (S8). Using the same instruments as in the operative theater and doing all dissection with the Harmonic ® shears, we were able to perform, in a way comparable to a procedure in patients, the steps of segment 8 resection. We recorded the procedure, illustrated the anatomy and assessed the satisfaction of trainees with this approach.Results: The video of a 3-port VATS right lower lobe anterior-basal segmentectomy (S8) in a 3D printed silicone model is provided. We choose a trans-fissure approach where the interlobar artery was identified followed by the isolation and stapling of A8, B8 and V8. The parenchyma was then stapled along the intersegmental plan to extract the segment. The approach was satisfactory for residents who found the exercise useful to train thoracoscopic movements, to understand anatomy and the stepwise approach.Conclusions: Simulation approaches are useful for the teaching of residents and could be a useful tool to integrate to the curriculum of trainees.

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Simulation as tool for evaluating and improving technical skills in laparoscopic gynecological surgery

Cited by 17 publications

References 23 publications

Development and validation of a simulator for teaching minimally invasive thoracic surgery in Brazil

Development and validation of a simulator for teaching minimally invasive thoracic surgery in Brazil

Simulation-based structured training for developing laparoscopy skills in general surgery and obstetrics & gynecology postgraduates

Learning of VATS right lower lobe anterior-basal segmentectomy (S8) on a 3D printed simulator

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