Abstract
Introduction
Exercise is beneficial to learning. The purpose of this research was to determine whether an episode of aerobic exercise prior to practice improves the acquisition and retention of laparoscopic skills in the fundamentals of laparoscopic surgery (FLS) simulator.
Methods
Baseline maximal physical fitness (VO2 max), performance on peg transfer (PT), pattern cut (PC), and intracorporeal suture (ICS) were measured for FLS naïve undergraduates. 2 Weeks later, participants were randomized into exercise (E) and control (C) groups. C did unrelated work for 40 min and then practiced PT and PC for 10 min, and ICS for 15 min. Final scores were recorded. In E, participants ran on a treadmill for 20 min at 60 % of their VO2 max. After a 15 min cool down, they engaged in identical FLS simulator training as group C. Both groups completed the NASA task load index (TLX) to assess workload. Retention was recorded 2 months after the training session. Groups were compared using t tests, χ2 and Wilcoxon rank tests. p < 0.05 was considered significant.
Results
There were 52 participants (22 in C; 30 in E) with high physical fitness at baseline. Demographics between the groups were similar at baseline. There were no differences in VO2 max and scores on the three tasks at baseline (all p values NS). There was no statistical significance between the scores of the C and E groups at the training session and retention, except for higher PT scores in the E group after the training session.
Conclusion
In physically fit, surgically naïve students, one bout of aerobic exercise enhanced immediate learning of simple FLS skills but did not have an impact on more complex skills or on retention. The use of exercise in the surgical curriculum, or as a learning tool, warrants further investigation regarding how best to apply it.
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Acknowledgments
We would like to acknowledge Drs. Ali Samkari and Yo Kurashima for their help with testing and scheduling. We also would like to thank all the participants.
Disclosures
Genevieve Chartrand, Pepa Kaneva, Andrew F. Mutter, and Drs. Nicole Kolozsvari, Andrea Petrucci and Franco Carli, have no conflicts of interest or financial ties to disclose. Drs. Chao Li and Stella S. Daskalopoulou are supported by Fonds de Recherche Santé Québec. Dr. Liane Feldman is a consultant for Covidien, receives an investigator-initiated research Grant from Ethicon, and has an unrestricted educational grant from Conmed. Dr. Gerald M. Fried has received unrestricted educational Grants from Covidien. Dr. Melina Vassiliou has received an unrestricted Grant to support research form Covidien Canada. The Steinberg Bernstein Centre receives an unrestricted educational Grant from Covidien. This Project was funded by a Grant from the SAGES Education and Research Foundation in 2012.
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Chartrand, G., Kaneva, P., Kolozsvari, N. et al. The effects of acute aerobic exercise on the acquisition and retention of laparoscopic skills. Surg Endosc 29, 474–480 (2015). https://doi.org/10.1007/s00464-014-3691-7
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DOI: https://doi.org/10.1007/s00464-014-3691-7