Development of Laparoscopic Suturing Skills: A Prospective Trial

PURPOSE: This multicenter regional trial aimed to evaluate prospectively whether a home-constructed training system comprised of a camcorder, standard television, and laparoscopic box trainer could be used to advance intracorporeal laparoscopic suturing skills. SUBJECTS AND METHODS: Ten urology residents attended a 1-hour teaching session on laparoscopic suturing at the outset of the study. Baseline times and quality assessment were recorded for single-knot intracorporeal laparoscopic sutures, performed on standard laparoscopic stack systems, directly after instruction. Four residents were assigned to train regularly for 4 to 8 weeks on the home-constructed system. All participants were reassessed after 4 weeks on standard laparoscopic stacks, and the times of the study group and controls were compared. RESULTS: Baseline times were not significantly different (p = 0.2764) between the study group and controls. However, the study-group times (111.3 +/- 6.874 [SEM] seconds) were significantly better (p < 0.0001) than those of the control subjects (202.2 +/- 16.96 seconds) after 4 weeks and an average of 303 minutes of total training time on the home-constructed system. Furthermore, subjects training on this system were more likely to throw an acceptable knot (100%) than were the controls (66%). Two subjects who trained for a further 4 weeks achieved greater improvement in facility. CONCLUSIONS: Intracorporeal suturing skills can be learned using a home-constructed system. This could be beneficial for those wishing to develop the advanced skills required for various laparoscopic urologic procedures.