Journal of Gastrointestinal Surgery

, Volume 17, Issue 3, pp 569–575 | Cite as

A Randomised Comparative Study Evaluating Learning Curves of Novices in a Basic Single-Incision Laparoscopic Surgery Task

  • Mikael Sodergren
  • Colleen McGregor
  • Hugo A. Farne
  • Jiguo Cao
  • Zhijun Lv
  • Sanjay Purkayastha
  • Thanos Athanasiou
  • Ara Darzi
  • Paraskevas Paraskeva
Original Article

Abstract

Objective

There is currently no objective quantification of the temporal changes in performance associated with a novice surgeon learning single-incision laparoscopic surgery (SILS) operative tasks. Analysing learning curves allows us to objectively quantify performance. The aim was to evaluate if the rate of learning and ultimate proficiency level reached in SILS when using straight or articulating instruments is different to conventional laparoscopy and if training in laparoscopy influences learning or proficiency for SILS.

Design and Setting

Thirty-six surgically naive medical students were randomised to complete the validated peg transfer task over 50 repetitions using a conventional laparoscopic set-up, SILS set-up with straight instruments or articulated instruments or SILS set-up after having reached proficiency using a conventional laparoscopy.

Results

There was a significant increased overall proficiency between the group trained in conventional laparoscopy and all other groups (p < 0.01), with no difference between the other groups. There was no difference in the rate of learning between the groups. There was no difference in the ultimate proficiency level (p = 0.671) or rate of learning (p = 0.63) when using straight or articulating instruments. There was no difference in ultimate proficiency level (p = 0.59) or learning rate (p = 0.219) seen in the SILS group that had prior training on the task with a conventional laparoscopic set-up.

Conclusions

The results of this study indicate that the proficiency reached using a conventional laparoscopic set-up cannot be matched using a SILS configuration for the novice surgeon and that the choice of straight or articulated instruments as well as previous laparoscopic training does not confer an advantage in this basic task.

Keywords

Single-incision laparoscopic surgery SILS Single port Laparoscopy Box trainer Learning curve 

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Copyright information

© The Society for Surgery of the Alimentary Tract 2012

Authors and Affiliations

  • Mikael Sodergren
    • 1
  • Colleen McGregor
    • 1
  • Hugo A. Farne
    • 1
  • Jiguo Cao
    • 2
  • Zhijun Lv
    • 3
  • Sanjay Purkayastha
    • 1
  • Thanos Athanasiou
    • 1
  • Ara Darzi
    • 1
  • Paraskevas Paraskeva
    • 1
  1. 1.Academic Surgical Unit, Department of Surgery, Division of Surgery and CancerImperial College LondonPaddingtonUK
  2. 2.Department of Statistics and Actuarial ScienceSimon Fraser UniversityBurnabyCanada
  3. 3.Department of DentistryPeople’s HospitalLaiwuChina

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