OBJECTIVE: To compare the effectiveness and cost of 2 ex vivo training curricula for laparoscopic suturing. BACKGROUND: Although simulators have been developed to teach laparoscopic suturing, a barrier to their wide implementation in training programs is a lack of knowledge regarding their relative training benefit and their associated cost. METHOD: This prospective single-blinded randomized trial allocated 24 surgical residents to train to proficiency using either avirtual reality (VR) simulator or box trainer. All residents then placed intracorporeal laparoscopic stitches during a Nissen fundoplication on a patient. The operating room (OR) cases were video-recorded and technical proficiency was assessed using 2 validated tools. OR performance of both groups was compared to that of conventionally trained residents and to fellowship-trained surgeons. A cost analysis of box training, VR training, and conventional residency training across Canadian surgical programs was performed. RESULTS: After ex vivo training, no significant differences in laparoscopic suturing in the OR were found between the 2 groups with respect to time (P = 0.74)-global rating score (P = 0.65) or checklist score (P = 0.97). It took conventionally trained residents 6 practice attempts in the OR to achieve the technical proficiency of the ex vivo trained groups (P = 0.83). VR training was more efficient than box training (transfer effectiveness ratio of 2.31 vs 1.13). The annual cost of training 5 residents on the FLS trainer box was $11,975.00, on the VR simulator was $77,500.00, and conventional residency training was $17,380.00. Over 5 years, box training was the most cost-effective option for all programs, and VR training was more cost-effective for programs with more 10 residents. CONCLUSIONS: Training on either a VR simulator or on a box trainer significantly decreased the learning curve necessary to learn laparoscopic suturing. VR training, however, is the more efficient training modality, whereas box training the more cost-effective option.
RCT Entities:
OBJECTIVE: To compare the effectiveness and cost of 2 ex vivo training curricula for laparoscopic suturing. BACKGROUND: Although simulators have been developed to teach laparoscopic suturing, a barrier to their wide implementation in training programs is a lack of knowledge regarding their relative training benefit and their associated cost. METHOD: This prospective single-blinded randomized trial allocated 24 surgical residents to train to proficiency using either a virtual reality (VR) simulator or box trainer. All residents then placed intracorporeal laparoscopic stitches during a Nissen fundoplication on a patient. The operating room (OR) cases were video-recorded and technical proficiency was assessed using 2 validated tools. OR performance of both groups was compared to that of conventionally trained residents and to fellowship-trained surgeons. A cost analysis of box training, VR training, and conventional residency training across Canadian surgical programs was performed. RESULTS: After ex vivo training, no significant differences in laparoscopic suturing in the OR were found between the 2 groups with respect to time (P = 0.74)-global rating score (P = 0.65) or checklist score (P = 0.97). It took conventionally trained residents 6 practice attempts in the OR to achieve the technical proficiency of the ex vivo trained groups (P = 0.83). VR training was more efficient than box training (transfer effectiveness ratio of 2.31 vs 1.13). The annual cost of training 5 residents on the FLS trainer box was $11,975.00, on the VR simulator was $77,500.00, and conventional residency training was $17,380.00. Over 5 years, box training was the most cost-effective option for all programs, and VR training was more cost-effective for programs with more 10 residents. CONCLUSIONS: Training on either a VR simulator or on a box trainer significantly decreased the learning curve necessary to learn laparoscopic suturing. VR training, however, is the more efficient training modality, whereas box training the more cost-effective option.
Authors: Amine Chellali; Helena Mentis; Amie Miller; Woojin Ahn; Venkata S Arikatla; Ganesh Sankaranarayanan; Suvranu De; Steven D Schwaitzberg; Caroline G L Cao Journal: Int J Hum Comput Stud Date: 2016-07-09 Impact factor: 3.632
Authors: Jose Quezada; Pablo Achurra; Cristian Jarry; Domenech Asbun; Rodrigo Tejos; Martín Inzunza; Gabriel Ulloa; Andres Neyem; Carlos Martínez; Carlo Marino; Gabriel Escalona; Julian Varas Journal: Surg Endosc Date: 2019-07-30 Impact factor: 4.584
Authors: Sarah B Placek; Brenton R Franklin; Sarah M Haviland; Mercy D Wagner; Mary T O'Donnell; Chad T Cryer; Kristen D Trinca; Elliott Silverman; E Matthew Ritter Journal: Surg Endosc Date: 2016-10-12 Impact factor: 4.584
Authors: Michael J Chen; Aditee Ambardekar; Susan M Martinelli; Lauren K Buhl; Daniel P Walsh; Lior Levy; Cindy Ku; Lindsay A Rubenstein; Sara Neves; John D Mitchell Journal: J Educ Perioper Med Date: 2022-04-01