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Zhou X, Shao Y, Wu C, Zhang L, Wang J, Pan R, Sun J, Hu W. Application of a highly simulated and adaptable training system in the laparoscopic training course for surgical residents: Experience from a high-volume teaching hospital in China. Heliyon 2023; 9:e13317. [PMID: 36825174 PMCID: PMC9941944 DOI: 10.1016/j.heliyon.2023.e13317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 01/10/2023] [Accepted: 01/27/2023] [Indexed: 02/05/2023] Open
Abstract
Objective To explore the effectiveness, feasibility, and training effect of a highly simulated and adaptable laparoscopic training system in the advanced integrated two-stage laparoscopic simulation training course for surgical residents. Methods This study prospectively took the surgical residents who received the advanced integrated two-stage laparoscopic simulation training course in our hospital from December 2019 to December 2021 as the research objects. In the stage one course, the trainees are randomly distributed into the dry simulation system group and Darwin laparoscopic training system group. The subjective assessment results of the trainees from the two groups are collected by questionnaires, and the simulation assessment results of the two groups are evaluated in a unified, objective, and standardized assessment form. The pre-course and post-course questionnaires were used to evaluate the feasibility and effectiveness of the Darwin system in the stage two course. Results A total of 62 trainees completed the stage one and stage two courses. In the stage one course, the trainees were randomly distributed into the dry simulation trainer group (N = 19) and the Darwin group (N = 43). The results of the subjective assessment questionnaire showed that compared with the dry simulator group, the students in the Darwin group had higher subjective scores (P < 0.05). The objective assessment results for the 3 modules of "One Track Transfer", "One Tunnel Pass" and "High and Low Pillars" in the Darwin group were significantly better than those in the dry simulator group (P < 0.05). The trainees who received the stage two course completed the questionnaires before and after the course. The results showed that compared with pre-course evaluation, "basic theoretical knowledge of laparoscopy", "basic skills of laparoscopy", "laparoscopic suture technique" and "camera-holding technique" were significantly improved after training (P < 0.05). Conclusion The highly simulated and adaptable laparoscopic training system is effective and feasible in the advanced integrated two-stage laparoscopic simulation training course for surgical residents.
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Affiliation(s)
- Xueliang Zhou
- Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China,Shanghai Minimally Invasive Surgery Center, Shanghai, 200025,China
| | - Yanfei Shao
- Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China,Shanghai Minimally Invasive Surgery Center, Shanghai, 200025,China
| | - Chao Wu
- Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China,Shanghai Minimally Invasive Surgery Center, Shanghai, 200025,China,Department of Teaching and Research Section of Surgery, Ruijin Clinical Medical College, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Luyang Zhang
- Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China,Shanghai Minimally Invasive Surgery Center, Shanghai, 200025,China,Department of Teaching and Research Section of Surgery, Ruijin Clinical Medical College, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Jiayu Wang
- Ruijin Clinical Medical College, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China,Department of Medical Simulation, Ruijin Clinical Medical College, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Ruijun Pan
- Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China,Shanghai Minimally Invasive Surgery Center, Shanghai, 200025,China,Department of Teaching and Research Section of Surgery, Ruijin Clinical Medical College, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China,Department of Medical Simulation, Ruijin Clinical Medical College, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China,Corresponding author. Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China ,
| | - Jing Sun
- Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China,Shanghai Minimally Invasive Surgery Center, Shanghai, 200025,China,Department of Teaching and Research Section of Surgery, Ruijin Clinical Medical College, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China,Corresponding author. Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China,
| | - Weiguo Hu
- Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China,Shanghai Minimally Invasive Surgery Center, Shanghai, 200025,China,Department of Teaching and Research Section of Surgery, Ruijin Clinical Medical College, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China,Ruijin Clinical Medical College, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
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Bhatia VP, Wolf J, Farhat WA, Lewis B, Gralnek DR, Eliceiri KW, O'Kelly F. External validation of a low fidelity dry-lab platform to enhance loupes surgical skills techniques for hypospadias repair. J Pediatr Urol 2022; 18:765.e1-765.e6. [PMID: 35644791 DOI: 10.1016/j.jpurol.2022.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/22/2022] [Accepted: 04/30/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Hypospadias repair is an index pediatric urology procedure that requires trainee familiarity with surgical loupes. A previous low-fidelity, 6-step curriculum was proposed that deconstructed the most important steps of loupe surgery. We expanded on this curriculum with an intermediate-fidelity silicone hypospadias model and designed an abbreviated version of the 6-step curriculum to precede the hypospadias repair simulation. OBJECTIVE To assess the validity of our prior, low-fidelity conceptual model using the metric of improved performance on the intermediate-fidelity silicone hypospadias model. STUDY DESIGN A silicone model was first prototyped with the design software Solidworks™, and then fabricated using a cast made of a mixture of silicone rubbers designed to function like skin and soft tissue (Mold Star 20T, Dragon skin FX-pro and Slacker). Casts were used to create the penile shaft model and the dorsal hooded foreskin model. The urethral plate was cast separately on a flat surface. The model was then assembled by hand. The model used for simulation included the penile shaft and urethral plate, while the dorsal-hooded foreskin was prepared to simulate the penile anatomy separately. Trainees were then divided into two groups. Group 1 practiced the low-fidelity curriculum (3 tasks) and then performed dissection of the urethral plate and suturing using the intermediate-fidelity hypospadias model. Group 2 practiced hypospadias repair prior to the low-fidelity curriculum. Both groups' models were scored by 3 blinded urologists. Trainees were then asked to complete a post simulation satisfaction survey. Data analysis was performed in IBM SPSS Statistics for Macintosh (Version 28.0 Armonk, NY: IBM Corp). RESULTS Twenty-two candidates across Wisconsin, USA, and Dublin, Ireland participated in the study. This included 7 s-year residents, 9 third-year residents, 2 fourth-year residents, and 3 fifth-year residents. Both Groups 1 and 2 had a similar distribution of trainees (p = 0.60). Group 1 outperformed group 2 in all tasks (p < 0.05, Table 1). Trainees reported that the platform was very useful (91%). DISCUSSION Our curriculum showed improvement in trainee ability and comfort to perform hypospadias repair. Advantages of such a simulated curriculum include improving current resident training in microsurgery, improving surgical ergonomics for trainees prior to real-time experience, and decreasing the learning curve for trainees pursuing pediatric urology. CONCLUSION An intermediate-fidelity hypospadias platform externally validates the conceptual model implemented in the low-fidelity loupes curriculum. This appears to lead to improvement in loupe surgical skills regardless of trainee level.
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Affiliation(s)
- V P Bhatia
- Division of Pediatric Urology, Women and Children's Hospital, University of Wisconsin School of Medicine and Public Health, USA.
| | - J Wolf
- Department of Biomedical Engineering, University of Wisconsin-Madison College of Engineering, USA; Morgridge Institute for Research, Madison, WI, USA
| | - W A Farhat
- Division of Pediatric Urology, Women and Children's Hospital, University of Wisconsin School of Medicine and Public Health, USA
| | - B Lewis
- Division of Pediatric Urology, Women and Children's Hospital, University of Wisconsin School of Medicine and Public Health, USA
| | - D R Gralnek
- Division of Pediatric Urology, Women and Children's Hospital, University of Wisconsin School of Medicine and Public Health, USA
| | - K W Eliceiri
- Department of Biomedical Engineering, University of Wisconsin-Madison College of Engineering, USA; Morgridge Institute for Research, Madison, WI, USA
| | - F O'Kelly
- Division of Pediatric Urology, Women and Children's Hospital, University of Wisconsin School of Medicine and Public Health, USA; Division of Paediatric Urology, Beacon Hospital, University College Dublin, Ireland
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Ackermann J, Pahls J, Baumann J, Spüntrup C, Holthaus B, Noé G, Anapolski M, Meinhold-Heerlein I, Laganà AS, Peters G, Pape J, Willer D, Westermann AM, Günther V, Maass N, Mettler L, Alkatout I. The pelvitrainer for training in laparoscopic surgery – A prospective, multicenter, interdisciplinary study: Experimental research. Int J Surg 2022; 101:106604. [DOI: 10.1016/j.ijsu.2022.106604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/29/2022] [Indexed: 11/28/2022]
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Balogun OS, Osinowo AO, Bode CO, Atoyebi OA. Survey of Basic Laparoscopic Training Exposure of Nigerian Postgraduate Trainees. Niger J Surg 2019; 25:172-176. [PMID: 31579372 PMCID: PMC6771176 DOI: 10.4103/njs.njs_38_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background: The practice of laparoscopy involves the use of training models that are different from conventional open surgery. These concepts are not captured in the traditional models of surgical residency training. Residency training in surgery has been seen as an ample opportunity for early introduction and training in laparoscopy. Objectives: This study aimed to assess the level of exposure and training experience of some surgical resident doctors in accredited training institutions in Nigeria on laparoscopy. Methodology: A cross-sectional survey was conducted among the resident doctors undergoing revision course in surgery at the National Orthopaedic Hospital, Igbobi, Lagos, and Lagos University Teaching Hospital, Lagos, in March 2018. Using the quantitative method of data collection, a pre-tested structured questionnaire was used to collect information on the demography and training exposure of the residents in laparoscopy. Results: A total of 54 of 96 residents surveyed returned the questionnaire, giving a response rate of 56%. There were 53 (98.1%) males and 1 (1.9%) female. The age range of the respondents was between 30 and 46 years, with a mean of 34.2 ± 3.96 years. Thirty-two (59.3%) respondents had spent at least 2 years training in surgery. Thirty-six (66.7%) respondents had not participated in more than four laparoscopic procedures during their rotation. Forty-six percent of respondents reported that their experience in laparoscopy was mainly by observation of the procedures. Forty-nine (90.7%) of respondents surveyed had not attended any training program in laparoscopy. Eighty-one (81.0%) of respondents had a strong motivation and desire for future practice of laparoscopy. Conclusion: This study revealed that few Nigerian postgraduate trainees sampled in the survey were exposed and had training experience in laparoscopy.
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Affiliation(s)
- Olanrewaju Samuel Balogun
- General Surgery Unit, Department of Surgery, College of Medicine, University of Lagos/Lagos University Teaching Hospital, Lagos, Nigeria
| | - Adedapo Olumide Osinowo
- General Surgery Unit, Department of Surgery, College of Medicine, University of Lagos/Lagos University Teaching Hospital, Lagos, Nigeria
| | - Christopher O Bode
- Paediatric Surgery Unit, Department of Surgery, College of Medicine, University of Lagos/Lagos University Teaching Hospital, Lagos, Nigeria
| | - Oluwole A Atoyebi
- General Surgery Unit, Department of Surgery, College of Medicine, University of Lagos/Lagos University Teaching Hospital, Lagos, Nigeria
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