Surgical Endoscopy

, Volume 24, Issue 11, pp 2830–2834

Resident perceptions of advanced laparoscopic skills training

  • Vanessa N. Palter
  • Neil Orzech
  • Rajesh Aggarwal
  • Allan Okrainec
  • Teodor P. Grantcharov

DOI: 10.1007/s00464-010-1058-2

Cite this article as:
Palter, V.N., Orzech, N., Aggarwal, R. et al. Surg Endosc (2010) 24: 2830. doi:10.1007/s00464-010-1058-2



The purpose of this study was to explore resident perceptions regarding four current models for teaching laparoscopic suturing and to assess the current quality of training in advanced minimally invasive surgical techniques at an academic teaching center.


This study included 14 senior general surgery residents (PGY 3-5) participating in a workshop in advanced laparoscopy. Four training tools were used in the course curriculum: the Fundamentals of Laparoscopic Surgery (FLS) black box suturing model, a synthetic Nissen fundoplication model, a virtual reality (VR) simulator suturing task, and a porcine jejuno-jejunostomy model. After the workshop, residents were asked to complete a questionnaire relating to their experience with laparoscopic surgery, and their opinions regarding the four training models. Model rank was analyzed with one-way ANOVA, and χ2 analysis with Fisher’s exact test was used to analyze model effectiveness.


The majority of residents had strong experience in basic laparoscopic cases such as cholecystectomy and appendectomy; however, few participants had experience in advanced cases. As a group, the residents ranked the porcine model first (average 1.6, median 1), followed by the synthetic Nissen model (average 2.0, median 2), the FLS model (average 2.5, median 3), and the VR trainer (average 3.2, median 4). Finally, each resident was asked to rate the four models individually with respect to their educational value. Scores were on a Likert scale from 1 to 5. Nine of 11 (81.8%) residents rated the animal model as “extremely helpful” while only 3 of 14 (21.4%) participants rated the VR model as “extremely helpful” (p = 0.048).


This study demonstrates that operative experience in advanced laparoscopy for senior residents is suboptimal. Residents learning this skill in a simulated environment prefer animal or video-trainers as teaching models rather than virtual reality. This has implications when designing a curriculum for advanced endoscopy.


Education Training/courses Simulation Laparoscopic suturing Education 

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Vanessa N. Palter
    • 1
  • Neil Orzech
    • 2
  • Rajesh Aggarwal
    • 3
  • Allan Okrainec
    • 4
  • Teodor P. Grantcharov
    • 5
  1. 1.Toronto General Hospital, The Wilson CentreTorontoCanada
  2. 2.Department of General SurgeryThe University of TorontoTorontoCanada
  3. 3.Department of Biosurgery and Surgical TechnologyImperial CollegeLondonUK
  4. 4.Department of General SurgeryThe Toronto Western HospitalTorontoCanada
  5. 5.Department of General SurgerySt. Michael’s HospitalTorontoCanada

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