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Training models in laparoscopy: a systematic review comparing their effectiveness in learning surgical skills

Wouter Willaert (UGent) , Dirk Van de Putte (UGent) , Katrien Van Renterghem (UGent) , Yves Van Nieuwenhove (UGent) , Wim Ceelen (UGent) and Piet Pattyn (UGent)
(2013) ACTA CHIRURGICA BELGICA. 113(2). p.77-95
Author
Organization
Abstract
Background : Surgery has traditionally been learned on patients in the operating room, which is time-consuming, can have an impact on the patient outcomes, and is of variable effectiveness. As a result, surgical training models have been developed, which are compared in this systematic review. Methods : We searched Pubmed, CENTRAL, and Science Citation index expanded for randomised clinical trials and randomised cross-over studies comparing laparoscopic training models. Studies comparing one model with no training were also included. The reference list of identified trials was searched for further relevant studies. Results : Fifty-eight trials evaluating several training forms and involving 1591 participants were included (four studies with a low risk of bias). Training (virtual reality (VR) or video trainer (VT)) versus no training improves surgical skills in the majority of trials. Both VR and VT are as effective in most studies. VR training is superior to traditional laparoscopic training in the operating room. Outcome results for VR robotic simulations versus robot training show no clear difference in effectiveness for either model. Only one trial included human cadavers and observed better results versus VR for one out of four scores. Contrasting results are observed when robotic technology is compared with manual laparoscopy. Conclusion : VR training and VT training are valid teaching models. Practicing on these models similarly improves surgical skills. A combination of both methods is recommended in a surgical curriculum. VR training is superior to unstructured traditional training in the operating room. The reciprocal effectiveness of the other models to learn surgical skills has not yet been established.
Keywords
PROFICIENCY, ROBOTIC SURGERY, MEDICAL-STUDENTS, SUTURING SKILLS, IMPROVES PERFORMANCE, OPERATING-ROOM, RANDOMIZED-CONTROLLED-TRIAL, VIRTUAL-REALITY SIMULATOR, ACQUISITION, BOX TRAINER

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Citation

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MLA
Willaert, Wouter, Dirk Van de Putte, Katrien Van Renterghem, et al. “Training Models in Laparoscopy: a Systematic Review Comparing Their Effectiveness in Learning Surgical Skills.” ACTA CHIRURGICA BELGICA 113.2 (2013): 77–95. Print.
APA
Willaert, Wouter, Van de Putte, D., Van Renterghem, K., Van Nieuwenhove, Y., Ceelen, W., & Pattyn, P. (2013). Training models in laparoscopy: a systematic review comparing their effectiveness in learning surgical skills. ACTA CHIRURGICA BELGICA, 113(2), 77–95.
Chicago author-date
Willaert, Wouter, Dirk Van de Putte, Katrien Van Renterghem, Yves Van Nieuwenhove, Wim Ceelen, and Piet Pattyn. 2013. “Training Models in Laparoscopy: a Systematic Review Comparing Their Effectiveness in Learning Surgical Skills.” Acta Chirurgica Belgica 113 (2): 77–95.
Chicago author-date (all authors)
Willaert, Wouter, Dirk Van de Putte, Katrien Van Renterghem, Yves Van Nieuwenhove, Wim Ceelen, and Piet Pattyn. 2013. “Training Models in Laparoscopy: a Systematic Review Comparing Their Effectiveness in Learning Surgical Skills.” Acta Chirurgica Belgica 113 (2): 77–95.
Vancouver
1.
Willaert W, Van de Putte D, Van Renterghem K, Van Nieuwenhove Y, Ceelen W, Pattyn P. Training models in laparoscopy: a systematic review comparing their effectiveness in learning surgical skills. ACTA CHIRURGICA BELGICA. 2013;113(2):77–95.
IEEE
[1]
W. Willaert, D. Van de Putte, K. Van Renterghem, Y. Van Nieuwenhove, W. Ceelen, and P. Pattyn, “Training models in laparoscopy: a systematic review comparing their effectiveness in learning surgical skills,” ACTA CHIRURGICA BELGICA, vol. 113, no. 2, pp. 77–95, 2013.
@article{3034635,
  abstract     = {Background : Surgery has traditionally been learned on patients in the operating room, which is time-consuming, can have an impact on the patient outcomes, and is of variable effectiveness. As a result, surgical training models have been developed, which are compared in this systematic review. 
Methods : We searched Pubmed, CENTRAL, and Science Citation index expanded for randomised clinical trials and randomised cross-over studies comparing laparoscopic training models. Studies comparing one model with no training were also included. The reference list of identified trials was searched for further relevant studies. 
Results : Fifty-eight trials evaluating several training forms and involving 1591 participants were included (four studies with a low risk of bias). Training (virtual reality (VR) or video trainer (VT)) versus no training improves surgical skills in the majority of trials. Both VR and VT are as effective in most studies. VR training is superior to traditional laparoscopic training in the operating room. Outcome results for VR robotic simulations versus robot training show no clear difference in effectiveness for either model. Only one trial included human cadavers and observed better results versus VR for one out of four scores. Contrasting results are observed when robotic technology is compared with manual laparoscopy. 
Conclusion : VR training and VT training are valid teaching models. Practicing on these models similarly improves surgical skills. A combination of both methods is recommended in a surgical curriculum. VR training is superior to unstructured traditional training in the operating room. The reciprocal effectiveness of the other models to learn surgical skills has not yet been established.},
  author       = {Willaert, Wouter and Van de Putte, Dirk and Van Renterghem, Katrien and Van Nieuwenhove, Yves and Ceelen, Wim and Pattyn, Piet},
  issn         = {0001-5458},
  journal      = {ACTA CHIRURGICA BELGICA},
  keywords     = {PROFICIENCY,ROBOTIC SURGERY,MEDICAL-STUDENTS,SUTURING SKILLS,IMPROVES PERFORMANCE,OPERATING-ROOM,RANDOMIZED-CONTROLLED-TRIAL,VIRTUAL-REALITY SIMULATOR,ACQUISITION,BOX TRAINER},
  language     = {eng},
  number       = {2},
  pages        = {77--95},
  title        = {Training models in laparoscopy: a systematic review comparing their effectiveness in learning surgical skills},
  volume       = {113},
  year         = {2013},
}

Web of Science
Times cited: