The animal model in advanced laparoscopy resident training

Abstract

Background and aim: Laparoscopic surgery is recognized as an established technique for several abdominal disorders. Aim of the present investigation was to assess the level of expertise of senior residents and to evaluate the role of the animal model on advanced laparoscopic training.

Methods: Overall, 60 residents underwent a training session on a porcine model under the guidance of experienced laparoscopic surgeons. Of these, 30 residents underwent a box-trainer preparation before starting the surgical procedure on the animal model, while a group of 20 repeated the course 3 months after the first session. Global Operative Assessment of Laparoscopic Skills (GOALS) was used to evaluate technical proficiency.

Results: Senior residents presented low mean scores for all the GOALS domains for both for the minor and major surgical procedure. The box-trainer led to an improvement in suturing skills (P<0.001). Comparison of the mean GOALS scores from the first to the second laparoscopic session demonstrated a significant improvement on the duration of the procedures (P<0.05), onset of major complications (P=0.01), need of the tutor (P=0.08), and confidence in treating intraoperative bleeding (P=0.01).

Conclusions: National Resident Training Programs should take into consideration the present quality of training and attempt to develop alternative methods of training for laparoscopic surgery, such as, the animal model laboratory.