Novices’ learning curve in single-port surgery using three surgical training programs

Abstract

Background

The objective of this study was to evaluate the novices’ learning curves and proficiency level reached in laparoendoscopic single-site (LESS) surgery using three surgical training programs.

Material and methods

Participants were randomly divided into three groups, who trained in a specific practice regimen for 12 days using a laparoscopic box simulator and three tasks. Group A trained in three stages using conventional laparoscopic surgery (CLS) with straight instruments, and LESS with straight and articulating instruments for four days each. Group B trained in two stages in LESS with straight and articulating instruments for six days each. Group C trained only in LESS with articulating instruments exclusively for all 12 days. Performance was registered daily during the 12 days to evaluate the participants’ progress.

Results

Pre- and post-training analysis of the three groups showed significant differences in performance, denoting the significant improvement in their LESS skills, with no difference between the groups. Group C reached a high level of technical competence with their specific training program in LESS, obtaining a lower asymptote and slow learning rate.

Conclusion

Specific training programs in LESS settings using articulated instruments showed a slower learning rate than the other programs but better proficiency in the technique with the best surgical performance.

Keywords:

• Laparoscopy
• learning curve
• single-incision
• performance analysis
• training programs
• simulation

Disclosure statement

The authors declare that they have no conflict of interest with respect to the research, authorship, or publication of this article.

Additional information

Funding

This work was supported by the UNAM-DGAPA-PAPIIT program with the project number IT200820.