The purpose of the study was to test a home built, easily portable laparoscopic trainer with a realistic, mobile camera for resident training. We sought to compare outcomes after an instructor training session vs. an online self study instructional video.
MATERIALS AND METHODS:
A box trainer was built using a suitcase, spy camera with LED light source mounted in a metal tube, and a camera receiver with wireless connection to a small TV screen, for under $200. All materials including laparoscopic graspers and knot pushers fit inside the suitcase for transport. Residents were given five tasks to complete on their own including passing a pipe cleaner through hooks, placing washers on pegs, unwrapping an aluminum foil ball, tracing a maze, and extracorporeal knot tying. They were randomized to direct instruction on the use of the trainer (controls) vs. self study using a video posted on YouTube. Self reported timed results for each task were compared, stratified by level of training. They also completed a questionnaire on realistic feel, technical problems with box trainer, comfort with trainer, need for the trainer and surgical applicability of the trainer using a Likert-type scale (1 = strongly disagree, 5 = strongly agree).
The apparatus is presented in figure 1. Eighteen residents were randomized to a 25 minute session with an instructor or to the video. There was no difference in outcomes in timed performance for each task between the two groups as presented in Table 1. There was a relationship between increasing PGY level and performance, suggesting validity of the tasks. Control and video groups reported no differences in technical problems with equipment (1.7 vs 2.7, P = 0.9),comfort with trainer (4.9 vs 4.8, P = 0.66), realistic simulation of surgical feel(4.6 vs 4.6, P = 1.0), applicability of tasks (4.9 vs 4.6, P = 0.13), and current opportunity for practice(2.3 vs 2.1, P = 0.61).
A homemade, realistic laparoscopic simulator can be inexpensively built and used for resident training at home with self instruction with good results. This can favorably impact time available for practice of laparoscopic skills and demands on faculty and finances.