PURPOSE: Difficulties at the beginning of the learning curve in minimally invasive surgery (MIS) can well be overcome by simulation outside the operating room. Despite a great number of available devices, standardized, structured, and validated training curricula for video simulators are scarce. METHODS: The Lübeck Toolbox (LTB) video trainer provides six training modules and online video tutorials. Proficiency levels for the tasks were defined by performance analysis of MIS experts (n = 15). Mean values of the best performed repetitions were set as benchmarks for a validation study with n = 30 MIS novices and the learning curves calculated. The novices performed a cholecystectomy on a pig organ model before and after the curriculum which were analyzed using the GOALS score. RESULTS: Benchmarks defined by expert performance for the task Nos. 1 to 6 were 72 s (± 8) (Pack Your Luggage), 49 s (± 9) (Weaving), 66 s (± 10) (Chinese Jump Rope), 89 s (± 28) (Triangle Cut), 138 s (± 44) (Hammer Cut), and 98 (± 22) (Suturing). The median numbers of required repetitions by the novices to reach the proficiency level were n = 42 (7-80), n = 26 (9-55), n = 32 (14-77), n = 44 (15-59), n = 19 (6-68), and n = 26 (15-60). These values were all located at the beginning of the plateau phase of the learning curves. GOALS score improved significantly after completion of the curriculum (18.0 (± 2.6) vs. 10.9 (± 1.6), p < 0.0001). CONCLUSION: The LTB curriculum constitutes a new highly standardized and proficiency level-based training program for basic skills in MIS. Transferability of the task content to a (sub)-realistic environment could be demonstrated. Still, future trials will have to further validate the effectiveness of the LTB curriculum.
PURPOSE: Difficulties at the beginning of the learning curve in minimally invasive surgery (MIS) can well be overcome by simulation outside the operating room. Despite a great number of available devices, standardized, structured, and validated training curricula for video simulators are scarce. METHODS: The Lübeck Toolbox (LTB) video trainer provides six training modules and online video tutorials. Proficiency levels for the tasks were defined by performance analysis of MIS experts (n = 15). Mean values of the best performed repetitions were set as benchmarks for a validation study with n = 30 MIS novices and the learning curves calculated. The novices performed a cholecystectomy on a pig organ model before and after the curriculum which were analyzed using the GOALS score. RESULTS: Benchmarks defined by expert performance for the task Nos. 1 to 6 were 72 s (± 8) (Pack Your Luggage), 49 s (± 9) (Weaving), 66 s (± 10) (Chinese Jump Rope), 89 s (± 28) (Triangle Cut), 138 s (± 44) (Hammer Cut), and 98 (± 22) (Suturing). The median numbers of required repetitions by the novices to reach the proficiency level were n = 42 (7-80), n = 26 (9-55), n = 32 (14-77), n = 44 (15-59), n = 19 (6-68), and n = 26 (15-60). These values were all located at the beginning of the plateau phase of the learning curves. GOALS score improved significantly after completion of the curriculum (18.0 (± 2.6) vs. 10.9 (± 1.6), p < 0.0001). CONCLUSION: The LTB curriculum constitutes a new highly standardized and proficiency level-based training program for basic skills in MIS. Transferability of the task content to a (sub)-realistic environment could be demonstrated. Still, future trials will have to further validate the effectiveness of the LTB curriculum.
Entities:
Keywords:
Education; Laparoscopy; Lübeck Toolbox; Minimally invasive surgery; Simulation; Training
Authors: Neal E Seymour; Anthony G Gallagher; Sanziana A Roman; Michael K O'Brien; Vipin K Bansal; Dana K Andersen; Richard M Satava Journal: Ann Surg Date: 2002-10 Impact factor: 12.969
Authors: Pascal Probst; Phillip Knebel; Kathrin Grummich; Solveig Tenckhoff; Alexis Ulrich; Markus W Büchler; Markus K Diener Journal: Ann Surg Date: 2016-07 Impact factor: 12.969
Authors: Melina C Vassiliou; Liane S Feldman; Christopher G Andrew; Simon Bergman; Karen Leffondré; Donna Stanbridge; Gerald M Fried Journal: Am J Surg Date: 2005-07 Impact factor: 2.565
Authors: Elif Bilgic; Yusuke Watanabe; Dmitry Nepomnayshy; Aimee Gardner; Shimae Fitzgibbons; Iman Ghaderi; Adnan Alseidi; Dimitrios Stefanidis; John Paige; Neal Seymour; Katherine M McKendy; Richard Birkett; James Whitledge; Erica Kane; Nicholas E Anton; Melina C Vassiliou Journal: Am J Surg Date: 2016-10-08 Impact factor: 2.565
Authors: Karl-Friedrich Kowalewski; Jonathan D Hendrie; Mona W Schmidt; Tanja Proctor; Sai Paul; Carly R Garrow; Hannes G Kenngott; Beat P Müller-Stich; Felix Nickel Journal: Surg Endosc Date: 2017-03-09 Impact factor: 4.584
Authors: Felix Nickel; Karl-Friedrich Kowalewski; Florian Rehberger; Jonathan David Hendrie; Benjamin Friedrich Berthold Mayer; Hannes Götz Kenngott; Vasile Bintintan; Georg Richard Linke; Lars Fischer; Beat Peter Müller-Stich Journal: Surg Endosc Date: 2016-06-17 Impact factor: 4.584
Authors: A Widder; J Backhaus; A Wierlemann; I Hering; S Flemming; M Hankir; C-T Germer; A Wiegering; J F Lock; S König; F Seyfried Journal: Surg Endosc Date: 2022-07-18 Impact factor: 3.453
Authors: Franziska Köhler; Lena Reese; Carolin Kastner; Anne Hendricks; Sophie Müller; Johan F Lock; Christoph-Thomas Germer; Armin Wiegering Journal: Front Surg Date: 2022-06-08