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Minimally invasive tele-mentoring opportunity—the mito project

  • 2019 SAGES Oral
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Simulation training is a validated method for acquiring laparoscopic skills. Training sessions may be sporadic or lack continuity in oversight by instructors since traditional programs mandate in-person teaching and evaluation. This study presents the development, implementation, and results of a novel smartphone application that enables remote teacher–student interaction. This interface is used to complete a validated program that provides learner-specific feedback. Outcomes of training via Lapp were compared to outcomes of traditional in-person training.

Methods

A web-based and mobile iOS and Android application (Lapp) was developed to enable a remote student–teacher interaction. Instructors use Lapp to assess video recorded training sessions of students at distant locations and guide them through the laparoscopic skill course with specific and personalized feedback. Surgical trainees at two remote training centers were taught using Lapp. A control group was assessed during traditional simulation training at the training facility, with in-person feedback. Pre- and post-training performances were video recorded for each trainee and blindly evaluated by two experts using a global rating scale (GRS) and a specific rating scale (SRS).

Results

A total of 30 trainees were trained via Lapp and compared with 25 locally taught. Performance in the Lapp group improved significantly after the course in both GRS and SRS scores, from 15 [6–17] to 23 [20–25], and from 12 [11–15] to 18 [15–20], respectively. The results between both groups were comparable.

Conclusion

Laparoscopic simulation training using a mobile app is as effective as in-person instruction in teaching advanced laparoscopic surgical skills. Lapp provides an effective method of teaching through simulation remotely and may allow expansion of robust simulation training curriculums.

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Authors and Affiliations

  1. Experimental Surgery and Simulation Center, Department of Digestive Surgery, Clinic Hospital, School of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 377, Santiago, Chile

    Jose Quezada, Pablo Achurra, Cristian Jarry, Rodrigo Tejos, Martín Inzunza, Carlos Martínez, Carlo Marino, Gabriel Escalona & Julian Varas

  2. Computer Science Department, Pontificia Universidad Católica de Chile, Santiago, Chile

    Gabriel Ulloa & Andres Neyem

  3. Department of Surgery, UCSF Fresno, Fresno, CA, USA

    Domenech Asbun

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  1. Jose Quezada
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  2. Pablo Achurra
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  3. Cristian Jarry
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  5. Rodrigo Tejos
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Correspondence to Julian Varas.

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Drs. Jose Quezada Pablo Achurra, Cristian Jarry, Domenech Asbun, Rodrigo Tejos, Martín Inzunza, Gabriel Ulloa, Andres Neyem, Carlos Martínez, Carlo Marino, Gabriel Escalona and Julian Varas for this study were financed and supported by a 2017 SAGES Research Grant and a Chilean Research Grant FONDECYT REG. 11170108 from CONICYT and by the Department of Digestive Surgery, Faculty of Medicine, Pontificia Universidad Católica de Chile. Dr Julian Varas is a cofounder of the company T&C, which manufactured the surgical simulators used in this study.

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Quezada, J., Achurra, P., Jarry, C. et al. Minimally invasive tele-mentoring opportunity—the mito project. Surg Endosc 34, 2585–2592 (2020). https://doi.org/10.1007/s00464-019-07024-1

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