Continuous Skill Training Using the Disease-Specific Endoscopic Surgical Simulator to Promote Young Pediatric Surgeons: Learning Curve for Trainees

Abstract Purpose: This study aimed to evaluate the learning effects of continuous training with a disease-specific endoscopic surgical simulator for young pediatric surgeons. Materials and Methods: Participants trained with a laparoscopic fundoplication simulator for 1 hour every 10 days. At the start of each training session, we assessed the participant's surgical technique using the surgical skill evaluation system, which evaluates the following items: (1) task time, (2) right–left balance of suturing, (3) suture spacing between the three ligatures, (4) total path length traveled by forceps, (5) velocity of the forceps tips, (6) length of the wrap, (7) number of ligature failures, and (8) comparison of improvements according to assessment point. We examined the learning effects of this continuous training program. Results: Task time, right–left balance of suturing, and sum of the distance traveled by each forceps showed significant progressive improvements ( P < .05). Suture spacing and average velocity of forceps tips did not change significantly with training ( P = .5781, P = .0781, respectively). However, the ratio of traveled distance between left and right forceps significantly improved ( P < .05). There was a significant trend for the wrap length to approach the target value ( P < .05). According to the linear mixed-effects model, the number of training sessions required for learning was not uniform and varied depending on the skill. Conclusion: This simulator training program can help pediatric surgeons to acquire surgical skills easily, economically, and safely. In the future, we need to evaluate how surgical skills acquired during this continuous training are reflected in clinical operations.