Role of testing before teaching basic laparoscopic skills

Background. The urgency of the problem with training specialists in laparoscopic techniques is due to the wide introduction of minimally invasive technologies into surgical practice. Previously untrained, a surgeon runs considerable difficulties with the coordination of movements and the use of tools, which may lead to both the longer life of surgical aids and damage to the viscera and vascular structures in a patient. Many factors influence the level of manual skills in the audience at the beginning of training, which further affect its duration and hence cost.

Objective. To evaluate the effect of initial level of basic manual skills for the duration of the study.

Materials and methods. The investigation enrolled 255 listeners: medical students, interns, residents, and practicing surgeons. Manual skills as single successive performance of exercises 1 (peg transfers) and 2 (cutting a circle) in an endotrainer box were tested before training. The correlation of the results of testing for the rate of formation of basic laparoscopic skills was then analyzed.

Results. According to the results of the testing, only 20 % of the physicians showed a result of less than 110 s and were ready for being further taught in intracorporeal suturing techniques. The authors consider that all students and interns/residents and most physicians must start their training in laparoscopic technique from a series of basic exercises. The analysis revealed a correlation between the results of doing exercises 1 and 2 and the number of their repetitions to achieve the needed level (r = 0.66).

Conclusion. The single performance of peg transfers and cutting a circle exercises before training could objectively measure the performance of laparoscopic skills, define an individual plan, and optimize the costs of the training.

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