Does the techniques for teaching of laparoscopic surgery to surgeons and registrars at North Queensland add

educational values?

Knowledge and attitude of surgeons and registrar in North Queensland about the different techniques for teaching laparoscopic surgery.

Dr Alfred Oghenemano Egedovo

INTRODUCTION:

What is Laparoscopy

• Picture and component of laparoscopy (Google )

Laparoscopy is a surgery that uses a thin, lighted tube put through a cut (incision) in the

belly to look at the abdominal organs

or the female pelvic organs

4

(Google image)

The first Laparoscopic Surgery

Laparoscopic cholecystectomy

operation was first done by Erich Muhe in 1985

and since then Laparoscopic procedure became the focus of all

surgeons.5

Gallbladder injury complication rate was

very high initially1

Laparoscopic Surgery Emerging trends

Laparoscopic Surgery have become a gold standard in

surgical Practice . Laparoscopic surgery had

spread into General Surgery, Gynaecology, urology .

Laparoscopic Surgery have brought innovation into the

surgical field. Laparoscopic Robotic Surgery Endoscopic reflux surgery

telepresence Surgery

Laparoscopic Surgery Training Traditional Training( Apprententship)

Stimulation Training(VRT)

(Google image)

(Google image)

Background Teaching of Laparoscopic Surgery

Operating room Based• Standard surgical training

has traditionally been one of apprenticeship, where the surgical trainee learns to perform surgery under the supervision of a trained surgeon. This is time-consuming, costly, and of variable effectiveness because of learning curve.2

Stimulations• There is high-grade evidence to

suggest that virtual reality simulators can support both training and assessment in laparoscopy surgery. Virtual reality training improves the technical skills of surgical trainees such as decreased time for suturing and improved accuracy. The educational impact of virtual reality training is not known1.

Background and LiteraturesLaparoscopic surgery training

Why teaching laparoscopic Surgery is important?• Michael Moore et.al highlight that laparoscopic surgery without

previous training increases complication(learning Curve) .2• There are voluminous paper that supported argument Virtual

reality stimulator ( MIST-VR) video improves laparoscopic surgery performance as argued by G.Ahlberg et.al.3

• Aggarwal. R et. al Argued in his work that the stimulator based training video has not proven persistence effectiveness over various cases. 1

• Does the Laparoscopic training video(VRT) used in NQ add educational value? ?? Problem to Research ! Research Question!!

Virtual Reality Training(VRT)

METHODOLOGY Design Of Study Descriptive study – Survey and interview of Surgeons and

Registrars in North Queensland

Participants and sampling 25 Consultant surgeons and 6 trainees in Townsville and Mackay Completed training in basic laparoscopic surgery and had used a

web-based training video within 1990 to 2013 (FLS development) Performed 10 -60 laparoscopic surgery within last two years Age 47 to retirement ( active surgeons)

Data CollectionThe collection of information will not involve patient data, therefore ethical issue is low risk no clinical sample to be collectedQualitative - interview of participants of topic questions Do you know of web-based training video, where?, cost , how you rate it, what you prefer ?Survey Questionnaires - using survey Monkey and anticipated 25%

return

AnalysisQuantitative methods would be used to determine (a) how attitudes toward laparoscopic surgical skills acquisitions from my interviewAnalysis of Variance (ANOVA) statistical method would be used to test differences between two or more variance opinion of the surgeons and registrar. Objective Structured Assessment of Technical Skill (OSATS) to assess their knowledgeLikernt response scale of 5 points

ResultsThe attitude and knowledge if positive from the statically calculation would be use to assess the value of the training.

ConclusionThe techniques of teaching laparoscopic surgery need to be assess to know the adaptability and its benefits to various settings.

References:1. Aggarwal R, Ward J, Balasundaram I, Sains P, Athanasiou T, Darzi A. Proving the effectiveness

of virtual reality simulation for training in laparoscopic surgery. Annals of Surgery. 2007;246(5):771-779.

2. Michael J. Moore, PhD,Charles L. Bennett, MD, PhD, The Learning Curve for Laparoscopic Cholecystectomy. Am J. Surgery VOLUME 170 JULY 1995

3. Ahlberg G, Heikkinen T, Iselius L, Leijonmarck CE, Rutqvist J, Arvidsson D. Does training in a virtual reality simulator improve surgical performance? Surgical Endoscopy and Other Interventional Techniques. 2002;16(1):126-129.

4. Nathaniel J. Soper LLS, W.Stephen Eubanks. Mastery of Endoscopic and Laparoscopic Surgery Lippincott Williams & Wilkins; 2009.

5 Philipp SR, Miedema BW, Thaler K. Single-incision laparoscopic cholecystectomy using conventional instruments: early experience in comparison with the gold standard. Journal of the American College of Surgeons. Nov 2009;209(5):632-637.