Nicoleta O Kolozsvari, MD, Pepa Kaneva, MSc, Melina C Vassiliou, MD, Gerald M Fried, MD, Liane S Feldman, MD. Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University, Montreal, QC, Canada
Introduction:
Exposure to laparoscopic surgery during medical school has increased over recent years. The Fundamentals of Laparoscopic Surgery (FLS) simulator allows for objective assessment of laparoscopic skill. The goal of this study was to determine whether the fundamental laparoscopic skills of incoming surgery residents have improved.
Methods and procedures:
The initial FLS performance of first-year surgical residents between 2003 and 2008 was identified from a prospective database. Linear regression was used to determine the effect of incoming year on performance of the five FLS tasks [peg transfer, pattern cut, endoloop placement, suture with extracorporeal knot (EC), suture with intracorporeal knot (IC)] and total score. Data are presented as mean±SD. Statistical significance is defined as p<0.05.
Results:
There were 65 first-year residents identified from the database. Scores for each task and total score are presented in the Table. Total FLS score improved over time (r=0.39, p=0.001). Scores for peg transfer did not significantly change, but scores for pattern cutting (r=0.37, p=0.002), endoloop placement (r=0.36, p=0.004), suture with EC (r=0.32, p=0.02) and suture with IC (r=0.26, p=0.03) all significantly improved over the five years.
Conclusion:
Baseline fundamental laparoscopic skills for incoming surgery residents appear to have improved over time. This may be due to increased clinical laparoscopic exposure and availability of laparoscopic simulation in medical school.
Table:
| Task | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | p |
|
Peg transfer |
47.9±22.0 | 39.7±19.4 | 42.2±26.5 | 56.6±24.2 | 40.4±23.1 | 58.5±31.1 | 0.34 |
| Pattern cut | 11.1±16.3 | 17.1±18.0 | 6.05±12.0 | 15.0±18.3 | 16.6±18.0 | 43.8±16.7 | 0.002 |
| Endoloop | 28.2±25.5 | 27.3±25.0 | 15.6±16.9 | 35.2±20.1 | 44.9±29.5 | 54.0±11.3 | 0.004 |
| EC | 26.9±27.5 | 29.6±24.6 | 26.0±21.5 | 28.7±33.8 | 45.5±26.6 | 54.7±26.5 | 0.01 |
| IC | 20.0±26.8 | 25.7±28.8 | 28.3±26.8 | 41.3±37.9 | 22.6±19.5 | 53.2±26.6 | 0.03 |
| Total score | 26.8±19.5 | 27.9±14.9 | 23.6±12.6 | 35.4±20.5 | 34.0±17.2 | 52.8±13.4 | 0.001 |
Session: Resident/Fellow
Program Number: S119