Improving laparoscopic skills using a novel pelvitrainer: A pilot study

Introduction: Simulators (Lap trainers) are essential for training surgeons on the basic and advanced laparoscopic skills. However, it is not available in most of our hospitals. The high cost and the difficulty in attending hands on training courses for the majority of surgeons in developing countries is reflected on the level of practice and on the patient's safety. In this study, there is an introduction and evaluation of a novel and cheap pelvitrainer, which could be an aid for training in laparoscopy in developing countries, as well as a brief account on the importance of having a structured training program.
Materials and methods: Thirty (n=30) general surgical residents, years 1 & 2 in training, at Ain Shams University Hospital, Cairo, Egypt, were enrolled in a prospective, randomized, controlled, double blind study. In the first study group (n=15), residents were randomly assigned to have one hour training using the new pelvitrainer for 3 consecutive days. The training exercises were composed of three levels of difficulty, starting with pick & place exercise, then precision cutting and lastly laparoscopic suturing. Following this, their ability to perform efficient laparoscopic dissection of the gall bladder bed during laparoscopic cholecystectomy in the operating theater, under supervision, was assessed by an independent observer who was a surgery consultant. Following this, the trainees were given questionnaires to evaluate the process. On the other hand, concurrently, a comparable number of residents controls (n=15), who have not been trained on the pelvitrainer, were also evaluated during performing the same operative procedure, under supervision. The results of the evaluations and questionnaires were subjected to statistical analysis.
Results: There was a statistically significant difference in the performance of surgical residents who have been trained on the new pelvitrainer in the study group and who successfully completed the three levels of pelvitrainer exercises compared to controls, which was shown by the time spent to perform the operative procedure and the number of mistakes. On the other hand, the degree of performance of the control and study groups together was also related to an independent factor which was the frequency of exposure to laparoscopic cholecystectomy. Residents in the study group showed increased interest in the new pelvitrainer.
Conclusion: The new pelvitrainer might be a useful and cheap adjunct to surgical resident training in our hospitals as well as others in developing countries.