Do laparoscopic pelvic trainer exercises improve residents' surgical skills? A randomized controlled trial.
Dubuisson JDepartment of Gynecology and Obstetrics, Gynecologic Division, Geneva University Hospitals, Geneva, Switzerland. Electronic address: jean.dubuisson@hcuge.ch.
Vilmin FDepartment of Gynecology and Obstetrics, Gynecologic Division, Geneva University Hospitals, Geneva, Switzerland.
Boulvain MDepartment of Gynecology and Obstetrics, Gynecologic Division, Geneva University Hospitals, Geneva, Switzerland.
Combescure CCRC & Division of Clinical Epidemiology, Department of Health and Community Medicine, University of Geneva & University Hospitals of Geneva, Switzerland.
Petignat PDepartment of Gynecology and Obstetrics, Gynecologic Division, Geneva University Hospitals, Geneva, Switzerland.
Brossard PDepartment of Gynecology and Obstetrics, eHnv, Yverdon-Les-Bains, Switzerland.
English
OBJECTIVE The impact of surgical simulation devices on the training of gynecology residents has not been well defined. The aim of this study was to investigate whether the use of a laparoscopic pelvic trainer improved the surgical performance of residents.
STUDY DESIGN This randomized controlled trial enrolled gynecology residents who were randomized into group A or group B in a 1:1 fashion. All participants performed three pelvitrainer assessments (T1, T2, T3) consisting of suturing a 4-cm incision in a porcine bladder. The baseline assessment (T1) was performed before training. Group A underwent training before the second assessment (T2) and group B underwent training between the second and third assessments (T3).
RESULTS A total of 26 residents were enrolled (group A, n=14; group B, n=12). At the first assessment (T1), there was no significant difference in the time taken to perform the procedure between the two groups (group A, 30min vs group B, 30min; p=.35), indicating homogeneity of the two groups. At T2, there was a difference between the two groups in the time taken to perform the leak-free closer (group A, 19min vs group B, 30min; p=.08). The time taken to complete the procedure was shorter after training for each group: 30min (T1) vs 19min (T2); p=.02 for group A and 30min (T2) vs 17min (T3); p=.009 for group B. Residents in group A did not receive any training during the 4-week period between T2 and T3, but their acquired skills persisted during this time.
CONCLUSION The training on a laparoscopic pelvic trainer improves the surgical skills of residents, with performance persisting over time. It may be beneficial to use a laparoscopic pelvic trainer during residency programs.