Key result
Training with low-cost, homemade endotrainers significantly reduced mean task times for peg transfer (10.87 to 2.57 min, p=0.012) and other basic laparoscopic skills among surgical residents.
Why the study?
Effective laparoscopic training remains challenging in low-resource settings lacking formal simulation tools, necessitating evaluation of cost-effective alternatives such as homemade endotrainers.
Does one month of structured training using low-cost endotrainers improve basic laparoscopic skills in general surgery residents?
Observational (n=30)
Single-blind
No
Does one month of structured training using low-cost endotrainers improve basic laparoscopic skills in general surgery residents?
Absolute Event Rate: 2.57% vs 10.87%
p-value: p=0.012
Cost-effective, homemade endotrainers significantly improve basic laparoscopic skills among surgical residents, offering a scalable training solution for resource-limited settings.
May support low-cost endotrainers for resident laparoscopic training in resource-limited settings; hypothesis-generating and requires RCTs before practice change.
Background: Laparoscopic surgery is the preferred technique for many surgical procedures due to its minimal invasiveness and faster recovery, but effective training remains a challenge, especially in low-resource settings lacking formal simulation tools. There is a significant need to evaluate cost-effective alternatives, such as homemade endotrainers, to bridge the skill acquisition gap among surgical trainees. Objective: To assess the effectiveness of low-cost endotrainers in improving the laparoscopic skills—specifically peg transfer, ligating endoloop, intracorporeal knotting, and extracorporeal knotting—among postgraduate general surgical trainees over a one-month training period. Methods: This was a prospective observational study conducted at Lahore General Hospital with a sample of 30 third- and fourth-year general surgery residents. Inclusion criteria were residency status and willingness to participate; exclusion criteria included prior advanced laparoscopic training. Performance was assessed pre- and post-training using timed skill tasks and failure rates, evaluated by blinded laparoscopic surgeons. Ethical approval was granted by the Institutional Review Board, with all procedures adhering to the Helsinki Declaration. Data were analyzed using SPSS v27, employing paired sample t-tests and McNemar’s test to assess improvements. Results: Statistically significant improvements were observed in mean task times: peg transfer (10.87 to 2.57 min, p=0.012), endoloop (12.75 to 7.50 min, p=0.015), intracorporeal knotting (7.13 to 2.10 min, p=0.049), and extracorporeal knotting (11.67 to 3.33 min, p=0.015). Task failure rates also declined notably. Clinically, trainees demonstrated enhanced coordination, efficiency, and safety. Conclusion: Cost-effective, homemade endotrainers significantly improve basic laparoscopic skills among surgical residents, supporting their integration into surgical training, especially in resource-limited environments to enhance procedural safety and patient outcomes.
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Jabbar et al. (2024) conducted an observational in Laparoscopic surgical training (n=30). Low-cost homemade endotrainers vs. Pre-training baseline was evaluated on Mean task time for peg transfer (p=0.012). Training with low-cost, homemade endotrainers significantly reduced mean task times for peg transfer (10.87 to 2.57 min, p=0.012) and other basic laparoscopic skills among surgical residents.
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