Significant improvement of laparoscopic knotting time in medical students through manual training with potential cost savings in laparoscopy - an observational study

Abstract

Objective: Laparoscopy is a standard procedure in operative gynaecology, but laparoscopic simulator training for novices/junior surgeons is notcurrently well-established. The aims of this study were to demonstrate that a laparoscopic knot course for trainees can significantly shorten theknotting time and to perform a counter-value calculation for the clinic’s costs.Material and Methods: An observational study was performed with exercises on a laparoscopic box trainer as part of the practical clerkship ingynaecology and obstetrics between 07.10.2019-31.01.2020. At the beginning and at the end of the exercises, the participants made a laparoscopicknot and the difference in knotting time, Δt in seconds (s) was measured.Results: Eighty-eight medical students needed an average of 247.1 s for the first laparoscopic knot at the beginning of the course and an averageof 45.43 s for the second at the end of the course. Mean shortening of the knotting time was 201.67 s or 81.6% (p=0.02). Calculating costs of anaverage of €40-50 for an operation minute would mean a cost saving of at least €120-150 for a partial node.Conclusion: Trainees can significantly improve their operative skills in a short time with the aid of surgical simulation training. Such trainingcan be beneficial for clinics by reducing the operating time if the basics, such as sewing and instrument guidance, are learned on a simulator.We therefore suggest that operative simulation training should be mandatory in medical education. (J Turk Ger Gynecol Assoc 2020; 21: 150-5)