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Analysis of Laparoscopic Skills of General Surgery Residents in a Simulation Lab over 7 Years

Nicholas M Kunda, MD1, Charles Gruner, MD2, Blake Movitz, MD1. 1University of Illinois at Chicago – Metropolitan Group Hospitals, 2Presence Saint Francis Hospital

Introduction: Simulation is an integral part of surgical residency education and becoming certified in Fundamentals of Laparoscopic Surgery (FLS) is a requirement for general surgery residents to graduate. Here we examine general surgery residents’ performance on the five tasks tested for FLS certification in order to determine which tasks should be focused on inside and outside the simulation lab.

Methods & Procedures: From October 2009 through October 2016, 139 general surgery residents were evaluated during a minimally invasive rotation using the FLS Laparoscopic Trainer Box. Proficiency was analyzed in the following five areas: Peg Transfer, Precision Cutting, Ligating Loop, Suture with an Extracorporeal Knot, and Suture with an Intracorporeal Knot. Residents were proctored by a MIS attending physician.

Results: In the Peg Transfer Task, 100% of residents were able to complete the task. The average time of completion was 102s (range 41s – 261s). 4 residents performed an error (2.9%). In the Precision Cutting Task, 93% of residents were able to complete the task. The average time to complete the task was 162s (range 80s – 290s). 28 residents performed an error (20.1%). In the Ligating Loop Task, 92% of residents were able to complete the task. The average time to complete the task was 97s (range 43s – 253s). 21 residents performed an error (15.1%). In the Extracorporeal Knot Task, 92% of residents were able to complete the task. The average time to complete the task was 214s (range 100 – 405s). 44 residents performed an error (31.7%). In the Intracorporeal Knot Task, 89% of residents were able to complete the task. The average time to complete the task was 248s (range 72 – 565s). 10 residents performed an error (7.2%).

Conclusions: Residents had the highest completion rate and least amount of errors performed in the Peg Transfer Task. The Extracorporeal & Intracorporeal Knot Tasks were the most frequently failed exercises with the highest percentage of errors seen in Extracorporeal Knot Task. Accuracy and immediate improvement in time scores can be seen with teaching and attending direction on needle handling and suturing techniques. Therefore, residents should focus on Extracorporeal and Intracorporeal Knot Tasks while in the simulation lab.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 84753

Program Number: P317

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

42

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