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A Short Laparoscopic Drill That Improves Vaginal Cuff Closure at Different Institutions
Purpose: Evaluate whether a
laparoscopic simulation drill improves performance on a validated vaginal cuff
number of laparoscopic training materials available to teach gynecologic
procedures is increasing; however, there is a lack of evidence showing that
these methods result in improved surgical skills among obstetrics and
gynecology (OB-Gyn) trainees.
trainees at two academic institutions participated in laparoscopic
teaching (15 minutes per trainee) using the \"eyelet\"
simulation drill with a defined proficiency metric developed and
conducted by a fellowship trained minimally invasive gynecologic surgeon.
Pre- and post-teaching suturing tasks were recorded and scored blindly by the
same physician using a validated vaginal cuff model and the Global
Operative Assessment of Laparoscopic Skills (GOALS). Pre- and post-teaching
surveys were administered to assess laparoscopic experience, Fundamentals
of Laparoscopic Surgery (FLS) exposure, and opinions about the teaching.
Results: Among 25
participants, vaginal cuff suturing scores increased from a baseline median
score of 5 (interquartile range [IQR] 2-5) to 7 (IQR 5-8) after teaching
(p<0.001) with 92% of participants agreeing or strongly agreeing the
simulation teaching was helpful for learning laparoscopic skills. The majority
preferred the eyelet drill to FLS and felt the eyelet drill, rather than FLS,
should be used for training and assessment.
Discussions: Simulation teaching was
associated with improved vaginal cuff suturing performance. Short standardized
drills, like the eyelet drill, should be evaluated in a larger sample with the
ultimate goal of standardizing the Ob-Gyn laparoscopic training curriculum.
Minimally Invasive Surgery, Simulation, CME, GME, Practice-Based Learning & Improvement, Faculty, Resident, 2019, CREOG & APGO Annual Meeting,