Comparison of distance versus in-person laparoscopy training using a low-cost laparoscopy simulator—a randomized controlled multi-center trial

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Mark Enrik Geißler - , Else Kröner Fresenius Center for Digital Health, Universitätsmedizin Mannheim, Heidelberg University  (First author)
  • Jean Paul Bereuter - , Universitätsmedizin Mannheim, Heidelberg University  (Author)
  • Rona Berit Geissler - , Heidelberg University  (Author)
  • Guus Mattheus Johannes Bökkerink - , Princess Máxima Center for Pediatric Oncology (Author)
  • Luisa Egen - , Heidelberg University , German Cancer Research Center (DKFZ) (Author)
  • Karl Friedrich Kowalewski - , Heidelberg University , German Cancer Research Center (DKFZ) (Author)
  • Caelan Haney - , Heidelberg University , German Cancer Research Center (DKFZ) (Author)

Abstract

Introduction: Simulation training programs are essential for novice surgeons to acquire basic experience to master laparoscopic skills. However, current state-of-the-art laparoscopy simulators are still expensive, limiting the accessibility to practical training lessons. Furthermore, training is time intensive and requires extensive spatial capacity, limiting its availability to surgeons. New laparoscopic simulators offer a cost-effective alternative, which can be used to train in a digital environment, allowing flexible, digital and personalized laparoscopic training. This study investigates if training on low-cost simulators in a digital environment is comparable to in-person training formats. Materials and methods: From June 2023 to December 2023, 40 laparoscopic novices participated in this multi-center, prospective randomized controlled trial. All participants were randomized to either the ‟distance” (intervention) or the “in-person” (control) group. They were trained in a standardized laparoscopic training curriculum to reach a predefined level of proficiency. After completing the curriculum, participants performed four different laparoscopic tasks on the ForceSense system. Primary endpoints were overall task errors, the overall time for completion of the tasks, and force parameters. Results: In total, 40 laparoscopic novices completed digital or in-person training. Digital training showed no significant differences in developing basic laparoscopic skills compared to in-person training. There were no significant differences in median overall errors between both training groups for all exercises combined (intervention 3 vs. control 4; p value = 0.74). In contrast, the overall task completion time was significantly lower for the group trained digitally (intervention 827.92 s vs. control 993.42; p value = 0.015). The applied forces during the final assessment showed no significant differences between both groups for all exercises. Overall, over 90% of the participants rated the training as good or very good. Conclusion: Our study shows that students that underwent digital laparoscopic training completed tasks with a similar number of errors but in a shorter time than students that underwent in-person training. Nevertheless, the best strategies to implement such digital training options need to be evaluated further to support surgeons’ personal preferences and expectations.

Details

Original languageEnglish
Pages (from-to)6527-6540
Number of pages14
JournalSurgical endoscopy
Volume38
Issue number11
Publication statusPublished - Nov 2024
Peer-reviewedYes

External IDs

PubMed 39269479

Keywords

ASJC Scopus subject areas

Keywords

  • Laparoscopic skill analysis, Laparoscopy, Minimally invasive surgery, Simulation training