Do laparoscopic pelvic trainer exercises improve residents' surgical skills? A randomized controlled trial

Abstract

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.

Keywords: Box trainer; Gynecology; Laparoscopy; Simulation; Training.