Assessment of laparoscopic technical skills among surgery residents using a virtual simulator

ABSTRACT Introduction: The teaching of surgery has been undergoing changes and due to ethical, economic, and legal issues, the operating room is no longer the only setting for surgical education. Training with surgical simulators has emerged as an effective method, enabling skill development. Objective: Assessment of laparoscopic technical skills among general surgery residents after training on a virtual simulator and to determine if there is a difference in this skill acquisition based on the duration of the training sessions and between residents at different levels (R1 vs. R2) who received the same training opportunities. Method: A prospective longitudinal study was conducted with GS residents over 10 weeks using the Simbionix LapMentor® simulator. A test involving four basic laparoscopic tasks (Standard scissor cut, Grasping and clipping, Two-handed maneuver, and Electrocautery) was performed pre- and post-training on the simulator. Two training protocols were compared: Training 1 (distributed): four sessions of two hours each, with a two-week interval between them, and Training 2 (massive): two sessions of four hours, with a six-week interval between them. Results: There was a reduction in time and number of movements in all tasks. Regarding the type of training, the distributed training was faster in Task 3 (left hand). On the other hand, the massive training group collected more balls and lost fewer balls in Task 3 but spent more time with the cautery activated without proper contact with any band. Concerning the year of residency, R1 residents showed a reduction in the distance traveled with the left-hand instrument in Task 4 after SS training, while R2 residents did not (p=0.029). Conclusion: There was an improvement, with a reduction in both time and number of movements. Differences in training type were observed in left-hand speed, number of balls collected, number of balls lost in Task 3, and the time spent with the cautery activated without contact in Task 4. A difference in motor skills acquisition related to residency year was only observed in the distance traveled with the left-hand instrument in Task 4.