Surgical Endoscopy

, Volume 29, Issue 1, pp 113–118 | Cite as

Prospective randomized assessment of acquisition and retention of SILS skills after simulation training

  • Martin Varley
  • Ryan Choi
  • Kean Kuan
  • Neil Bhardwaj
  • Markus Trochsler
  • Guy Maddern
  • Peter Hewett
  • Soeren Torge Mees
Article

Abstract

Background

Skills in single-incision laparoscopic surgery (SILS) are difficult to acquire. Simulation training leads to skill acquisition but circumstances about skill deterioration are unclear. The aim of this study was to evaluate skill acquisition and retention after single-incision laparoscopic simulation training.

Methods

From October 2013 to January 2014, 30 surgically naive participants underwent a SILS training curriculum and completed two validated tasks (peg transfer, precision cutting) with subsequent testing to assess acquisition of skills (baseline testing, BT). The participants were randomized into two groups and skill retention testing (RT) was measured after 4 weeks (group A) or 12 weeks (group B). Task completion was measured in time with penalties for inaccurate performance.

Results

A SILS training curriculum was established. 90 % of the participants completed the training successfully and reached the required levels of proficiency. Comparison of BT and RT revealed significantly better RT performances for peg transfer and precision cutting in group A (P < 0.05). These effects were not seen for RT in group B. Evaluating the RT performance of both groups, group A showed a non-significant trend for improved peg transfer and precision cutting compared to group B.

Conclusion

A proficiency-based training curriculum for acquisition of basic SILS skills was successfully established in our department. The results of this study indicate that acquired SILS skills are well retained for a short period without training (4 weeks) but a longer non-training period (12 weeks) resulted in a significant loss of acquired skills. For enhancement of surgical skills, specialised SILS training curricula could be developed for novices and inexperienced surgeons; however, continuous training is essential to maintain these acquired skills.

Keywords

SILS Training Simulation Skill acquisition Skill retention 

References

  1. 1.
    Chow A, Purkayastha S, Aziz O, Pefanis D, Paraskeva P (2010) Single-incision laparoscopic surgery for cholecystectomy: a retrospective comparison with 4-port laparoscopic cholecystectomy. Arch Surg 145:1187–1191PubMedCrossRefGoogle Scholar
  2. 2.
    Prystowsky JB (2005) Are young surgeons competent to perform alimentary tract surgery? Arch Surg 140:495–500 discussion 500–492PubMedCrossRefGoogle Scholar
  3. 3.
    Barone JE, Lincer RM (1991) Correction: a prospective analysis of 1518 laparoscopic cholecystectomies. N Engl J Med 325:1517–1518PubMedGoogle Scholar
  4. 4.
    Scott DJ, Bergen PC, Rege RV, Laycock R, Tesfay ST, Valentine RJ, Euhus DM, Jeyarajah DR, Thompson WM, Jones DB (2000) Laparoscopic training on bench models: better and more cost effective than operating room experience? J Am Coll Surg 191:272–283PubMedCrossRefGoogle Scholar
  5. 5.
    Peters JH, Fried GM, Swanstrom LL, Soper NJ, Sillin LF, Schirmer B, Hoffman K (2004) Development and validation of a comprehensive program of education and assessment of the basic fundamentals of laparoscopic surgery. Surgery 135:21–27PubMedCrossRefGoogle Scholar
  6. 6.
    Islam A, Castellvi AO, Tesfay ST, Castellvi AD, Wright AS, Scott DJ (2011) Early surgeon impressions and technical difficulty associated with laparoendoscopic single-site surgery: a Society of American Gastrointestinal and Endoscopic Surgeons Learning Center study. Surg Endosc 25:2597–2603PubMedCrossRefGoogle Scholar
  7. 7.
    Montero PN, Acker CE, Heniford BT, Stefanidis D (2011) Single incision laparoscopic surgery (SILS) is associated with poorer performance and increased surgeon workload compared with standard laparoscopy. Am surg 77:73–77PubMedGoogle Scholar
  8. 8.
    Rieder E, Martinec DV, Cassera MA, Goers TA, Dunst CM, Swanstrom LL (2011) A triangulating operating platform enhances bimanual performance and reduces surgical workload in single-incision laparoscopy. J Am Coll Surg 212:378–384PubMedCrossRefGoogle Scholar
  9. 9.
    Santos BF, Enter D, Soper NJ, Hungness ES (2011) Single-incision laparoscopic surgery (SILS) versus standard laparoscopic surgery: a comparison of performance using a surgical simulator. Surg Endosc 25:483–490PubMedCrossRefGoogle Scholar
  10. 10.
  11. 11.
    Alevizos L, Brinkman W, Fingerhut A, Jakimowicz J, Leandros E (2012) Novice surgeons versus experienced surgeons in laparoendoscopic single-site (LESS) surgery: a comparison of performances in a surgical simulator. World J Surg 36:939–944PubMedCrossRefGoogle Scholar
  12. 12.
    Sodergren M, McGregor C, Farne HA, Cao J, Lv Z, Purkayastha S, Athanasiou T, Darzi A, Paraskeva P (2013) A randomised comparative study evaluating learning curves of novices in a basic single-incision laparoscopic surgery task. J Gastrointest Surg 17:569–575PubMedCrossRefGoogle Scholar
  13. 13.
    Pucher PH, Sodergren MH, Singh P, Darzi A, Parakseva P (2013) Have we learned from lessons of the past? A systematic review of training for single incision laparoscopic surgery. Surg Endosc 27:1478–1484PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Martin Varley
    • 1
  • Ryan Choi
    • 1
  • Kean Kuan
    • 1
  • Neil Bhardwaj
    • 1
    • 3
  • Markus Trochsler
    • 1
  • Guy Maddern
    • 1
  • Peter Hewett
    • 1
  • Soeren Torge Mees
    • 1
    • 2
  1. 1.Discipline of SurgeryUniversity of Adelaide, The Queen Elizabeth HospitalWoodvilleAustralia
  2. 2.Department of General and Visceral SurgeryUniversity Hospital of MuensterMuensterGermany
  3. 3.Department of Hepatobiliary SurgeryLeicester General HospitalLeicesterUK

Personalised recommendations