Complete Organ Laparoscopic Training System: A Novel Ex-Vivo Laparoscopic Simulator.

BACKGROUND

Previous ex vivo laparoscopic simulators have presented limitations in mimicking the thoracic and abdominal environment and lacked a teaching component. Therefore, we developed a complete organ laparoscopic training system (COLTS).

METHODS

The COLTS consists of complete clusters of living organs representing abdomen and thorax, a training platform, a specific circulation solution, and a teaching module. Twelve experts assessed the COLTS in terms of its simulation of the surgical environment and intervention using a Likert scale questionnaire. Twelve residents were randomly assigned groups with or without the teaching module. Trainees assessed COLTS and underwent performance evaluations based on operating time, blood loss, adverse events, and economy of movement.

RESULTS

Experts confirmed the ability of the COLTS to simulate the surgical environment and vessel pulse. All trainees positively evaluated the educational value of the COLTS. With the help of the teaching module, the trainees were more confident in the use of instruments (4.83 ± 0.41 vs. 3.83±0.98, p = 0.044) and positioning of trocars (4.67 ± 0.52 vs. 3.50 ± 0.84, p = 0.016) than were the trainees in the control group. Additionally, the teaching module group obtained better performance scores in terms of operation time (p = 0.008), reduced blood loss (p = 0.035), adverse events (p = 0.019), and economy of movement (p = 0.040), compared with the control group.

CONCLUSIONS

The COLTS is a useful and promising laparoscopic training system that simulates the thoracic and abdominal region. Furthermore, the teaching module can significantly improve the performance and participation of trainees.