BACKGROUND AND PURPOSE:

• This study by Patel et al. (Journal of Minimally Invasive Gynecology, 2016) sought to determine if the use of a porcine training model improves the skills of ObGyn residents performing laparoscopic salpingectomies.

METHODS:

• Randomized Control Trial (RCT)
• 22 OB/GYN residents performed a pre-intervention objective skills assessments test (OSAT) where they performed live human laparoscopic salpingectomy, after which they were randomized
  • The intervention group took part in one education session with a pre-session assigned reading, a 40-minute didactic lecture, watching of a procedural video, and simulation and practice of a laparoscopic salpingectomy using a porcine cadaver
  • The control group took part in traditional training
• All students then performed a second laparoscopic salpingectomy on a live patient
• Both surgeries were taped
  • Surgery tapes were scored by a single blinded evaluator for 9 OSAT indicators reflecting knowledge and skill
  • Secondary outcomes such as subjective measures of comfort with the surgery were assessed using surveys
  • A 5-point Likert scale was used (1=lowest score for OSAT and highest score for the subjective survey)

RESULTS:

• OSAT scores and comfort level measures did not change for the control group between the two surgeries
• The intervention group significantly improved in 2-handed surgery (pre: 2.8 ± 1.6, post: 3.5 ± 1.3; p = .004) and use of energy (pre: 2.9 ± 1.3, post: 3.6 ± 1.0; p = .01)
• The intervention group had an overall score change between the two procedures (pre: 26.7 ± 10.6, post: 29.9 ± 9.8; p ≤ .001)
• On survey analysis for secondary outcomes among the intervention group
  • Comfort in anatomy, steps of surgery, 2-handed surgery, and use of energy increased
  • Comfort in reading and learning in the operating room decreased

CONCLUSION:

• Simulation can significantly improve surgical technique OSAT scores for laparoscopic salpingectomy
• However, the authors note that while scores were statistically significantly improved, improvement was relatively small
• Average scores for both groups were less than optimum, indicating that more than the simulation intervention used in this study will be required to increase resident’s surgical skills

Learn More – Primary Sources:

Traditional Versus Simulation Resident Surgical Laparoscopic Salpingectomy Training: A Randomized Controlled Trial

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Diagnosing the Extrauterine Pregnancy-What You Need to Know