Randomized comparison of standard laparoscopic trainer to novel, at-home, low-cost, camera-less laparoscopic trainer.

OBJECTIVES To evaluate the utility of a portable, at-home, low-cost, camera-less laparoscopic trainer to provide laparoscopy training inexpensively and outside the constraints of the hospital environment. METHODS Twenty-two urology residents (postgraduate year 1 to 7) were tested prospectively on four basic laparoscopic tasks on a standard video laparoscopic trainer (pretest). Objective and subjective data were collected for each participant. The subjects were then randomized to 5 hours of training on either a portable, camera-less trainer (group 1) or a standard video laparoscopic trainer (group 2). Each resident was then retested on the initial same four laparoscopic tasks (post-test). Efficiency ratios were calculated for each task, incorporating both time and accuracy. Improvements between the pretest and post-test evaluations were compared between the two groups using the two-group t test. RESULTS All subjects significantly improved their performance with training. The average improvement in the time required to complete the laparoscopic tasks for all participants was 36%. Efficiency increased by 52%. However, no difference was found between the two groups. In the poststudy self-evaluations, 91% of participants in group 1 either agreed or strongly agreed that the at-home trainer was a helpful teaching modality. CONCLUSIONS The improvements in laparoscopic skills on our inexpensive, portable, at-home, camera-less trainer were not significantly different from those gained using a traditional video laparoscopic trainer. Participants trained on our portable trainer were able to improve objectively and subjectively by both external and internal evaluations. Thus, our system will allow trainees to develop their laparoscopic skills in an inexpensive manner in the comfort of their own home.

[1]  B. Guillonneau,et al.  Laparoscopic radical prostatectomy: the Montsouris experience. , 2000, The Journal of urology.

[2]  L R Kavoussi,et al.  Complications of laparoscopic pelvic lymph node dissection. , 1993, The Journal of urology.

[3]  P. Alken,et al.  Retroperitoneoscopy: experience with 200 cases. , 1998, The Journal of urology.

[4]  M F Whiteside,et al.  Halstedian Technique Revisited: Innovations in Teaching Surgical Skills , 1989, Annals of surgery.

[5]  Daniel B. Jones,et al.  Laparoscopic training on bench models: better and more cost effective than operating room experience? , 2000, Journal of the American College of Surgeons.

[6]  R. Clayman,et al.  Laparoscopic versus open radical nephrectomy: a 9-year experience. , 2000, The Journal of urology.

[7]  P. Fornara,et al.  Ergebnisse der bundesweiten Datenerhebung über die urologische Laparoskopie , 2002, Der Urologe A.

[8]  P Fornara,et al.  Complications of laparoscopic procedures in urology: experience with 2,407 procedures at 4 German centers. , 1999, The Journal of urology.

[9]  S. Loening,et al.  Laparoscopic Radical Prostatectomy , 2001, European Urology.

[10]  B. Guillonneau,et al.  Laparoscopic radical prostatectomy. , 2002, The Journal of urology.

[11]  Daniel B. Jones,et al.  Improving operative performance using a laparoscopic hernia simulator. , 2001, American journal of surgery.

[12]  R. Satava,et al.  Virtual Reality Training Improves Operating Room Performance: Results of a Randomized, Double-Blinded Study , 2002, Annals of surgery.

[13]  D. Scott,et al.  The impact of intense laparoscopic skills training on the operative performance of urology residents. , 2001, The Journal of urology.

[14]  M. Bridges,et al.  The financial impact of teaching surgical residents in the operating room. , 1999, American journal of surgery.

[15]  L R Kavoussi,et al.  Complications of laparoscopic nephrectomy in 185 patients: a multi-institutional review. , 1995, The Journal of urology.