Simulation-based camera navigation training in laparoscopy-a randomized trial. 2017

Cecilia Nilsson, and Jette Led Sorensen, and Lars Konge, and Mikkel Westen, and Morten Stadeager, and Bent Ottesen, and Flemming Bjerrum
Department of Obstetrics and Gynecology, The Juliane Marie Centre for Children, Women and Reproduction, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark. cecnilsson@gmail.com.

Inexperienced operating assistants are often tasked with the important role of handling camera navigation during laparoscopic surgery. Incorrect handling can lead to poor visualization, increased operating time, and frustration for the operating surgeon-all of which can compromise patient safety. The objectives of this trial were to examine how to train laparoscopic camera navigation and to explore the transfer of skills to the operating room. A randomized, single-center superiority trial with three groups: The first group practiced simulation-based camera navigation tasks (camera group), the second group practiced performing a simulation-based cholecystectomy (procedure group), and the third group received no training (control group). Participants were surgical novices without prior laparoscopic experience. The primary outcome was assessment of camera navigation skills during a laparoscopic cholecystectomy. The secondary outcome was technical skills after training, using a previously developed model for testing camera navigational skills. The exploratory outcome measured participants' motivation toward the task as an operating assistant. Thirty-six participants were randomized. No significant difference was found in the primary outcome between the three groups (p = 0.279). The secondary outcome showed no significant difference between the interventions groups, total time 167 s (95% CI, 118-217) and 194 s (95% CI, 152-236) for the camera group and the procedure group, respectively (p = 0.369). Both interventions groups were significantly faster than the control group, 307 s (95% CI, 202-412), p = 0.018 and p = 0.045, respectively. On the exploratory outcome, the control group for two dimensions, interest/enjoyment (p = 0.030) and perceived choice (p = 0.033), had a higher score. Simulation-based training improves the technical skills required for camera navigation, regardless of practicing camera navigation or the procedure itself. Transfer to the clinical setting could, however, not be demonstrated. The control group demonstrated higher interest/enjoyment and perceived choice than the camera group.

UI MeSH Term Description Entries
D010535 Laparoscopy A procedure in which a laparoscope (LAPAROSCOPES) is inserted through a small incision near the navel to examine the abdominal and pelvic organs in the PERITONEAL CAVITY. If appropriate, biopsy or surgery can be performed during laparoscopy. Celioscopy,Laparoscopic Surgical Procedures,Peritoneoscopy,Surgical Procedures, Laparoscopic,Laparoscopic Assisted Surgery,Laparoscopic Surgery,Laparoscopic Surgical Procedure,Procedure, Laparoscopic Surgical,Procedures, Laparoscopic Surgical,Surgery, Laparoscopic,Surgical Procedure, Laparoscopic,Celioscopies,Laparoscopic Assisted Surgeries,Laparoscopic Surgeries,Laparoscopies,Peritoneoscopies,Surgeries, Laparoscopic,Surgeries, Laparoscopic Assisted,Surgery, Laparoscopic Assisted
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000066908 Simulation Training A highly customized interactive medium or program that allows individuals to learn and practice real world activities in an accurate, realistic, safe and secure environment. Interactive Learning,Learning, Interactive,Training, Simulation
D000076142 Virtual Reality Using computer technology to create and maintain an environment and project a user's physical presence in that environment allowing the user to interact with it. Virtual Reality, Educational,Virtual Reality, Instructional,Educational Virtual Realities,Educational Virtual Reality,Instructional Virtual Realities,Instructional Virtual Reality,Realities, Instructional Virtual,Reality, Educational Virtual,Reality, Instructional Virtual,Reality, Virtual,Virtual Realities, Educational,Virtual Realities, Instructional
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D013337 Students, Medical Individuals enrolled in a school of medicine or a formal educational program in medicine. Medical Student,Medical Students,Student, Medical
D017081 Cholecystectomy, Laparoscopic Excision of the gallbladder through an abdominal incision using a laparoscope. Cholecystectomy, Celioscopic,Laparoscopic Cholecystectomy,Celioscopic Cholecystectomies,Celioscopic Cholecystectomy,Cholecystectomies, Celioscopic,Cholecystectomies, Laparoscopic,Laparoscopic Cholecystectomies
D055815 Young Adult A person between 19 and 24 years of age. Adult, Young,Adults, Young,Young Adults

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