Laparoscopic Surgery Simulation Model Compared to Standard Model

 


It could also reduce the length of the operation and decrease the proportion of patients having to stay overnight in the hospital. hospital when the trainee performs a hernia for the first time after having completed training using a simulation model. However, the duration of the benefit of training using a simulation model (i.e., whether this benefit continues in subsequent operations).

For minimally invasive surgery technique many of them have not received practical training with simulators Laparoscopic Needle Holder.

Quality of Evidence

A single trial involving 50 trainees was at low risk of bias (no risk of erroneous conclusions due to favoritism by investigators). Largely, the quality of the proof was very low.

Future Research

Further well-designed trials with less risk of bias due to inadequate study design or chance are needed. These trials should assess the long-term impact of training using a simulation model on clinical outcomes.

Authors' Conclusions:

There is sufficient evidence to determine whether training in laparoscopic surgery using a simulation model reduces mortality or morbidity. Very low-quality evidence indicates that it improves technical skills over standard surgical training in trainees with little prior experience. It could also reduce the duration of the operation and increase the proportion of patients discharged during the day with the first fully extra peritoneal laparoscopic hernia after training using a simulation model.

However, the duration of benefit from training using a simulation model is unknown. More well-designed trials with low risk of bias and random errors are needed. These trials should assess the long-term impact of training using a simulation model on clinical outcomes and compare training using a simulation model to other forms of training.

Context:

Surgical training has traditionally been an apprenticeship where the surgical trainee learns to perform a surgical procedure under the supervision of a trained surgeon. It is time consuming, expensive and of varying efficiency. Training using simulation models in the form of physical simulation is an option to supplement the standard training. However, the value of this modality on trainees with little prior laparoscopic experience.

Goals:

Compare the benefits and drawbacks of training using simulation models for trainees with little prior laparoscopic experience versus standard surgical training or additional training using an animal model.

Selection Criteria:

We scheduled to contain all randomized clinical trials matching training using simulation models against other methods of training, including standard laparoscopic training and additional training using an animal model for beginners with little experience. laparoscopic preliminary. We also planned to include trials comparing different training methods using simulation models.

Data Collection and Analysis:

Two authors identified the trials and collected the data. We analyzed the data with the fixed-effects model and the random-effects models using Review Manager. For each outcome, we calculated the relative risk (RR), the mean difference (MD) or the standardized mean difference (SMD) with 95% confidence intervals (CI) based on intention-to-treat analysis when possible.

Main Results:

We perceived nine preliminaries that fulfilled the expansion guidelines. One example including 18 Surgical students didn't add to the meta-assessment. We included nine preliminaries (283 careful students from numerous postgraduate years, going from first to fourth year) in which members were randomized for extra preparing utilizing recreation models (138 learners) as opposed to preparing standard (123). Just two beginnings (60 students) was a way of inclination. The reproduction models for preparing utilized in the seven were video test systems.

Six trials were conducted and selected one trial. The operations in which the final evaluation was performed included a laparoscopic hernia totally extra peritoneal, laparoscopic cholecystectomy, laparoscopic tubal ligation, laparoscopic partial salpingectomy, and laparoscopic bilateral mid-segment salpingectomy. The last evaluations were carried out on a single operating procedure.

Simulation Model Compared to Standard

No deaths were reported in three trials (additional training using a 0/82 (0%) simulation model compared to standard 0/86 (0%) training; RR not estimable; very low quality evidence). The other trials did not report on mortality. The estimated effect on serious adverse events was consistent with a beneficial effect and a harmful effect (three trials; 168 patients; additional training using a simulation model 0/82 (0%) compared to standard training 1/86 (1.1%); RR 0.36; 95% CI 0.02 to 8.43; very low quality evidence).

None of the trials reported the quality of life of the patients. Surgical time was significantly shorter in the additional training group using a simulation model compared to the standard training group (1 trial; 50 patients; DM -6.50 minutes; 95% CI -10.85 to -2.15). The proportion of patients discharged during the day was significantly higher in the additional training group using a simulation model compared to the standard training group (1 trial; 50 patients; additional training using a 24-hour simulation model (100%) compared to standard training 15/26 (57.7%); RR 1.71; 95% CI 1.23 to 2.37). None of the trials reported on trainee satisfaction. Operative performance was significantly better in the additional training group using a simulation model compared to the standard training group (seven trials; 249 trainees; SMD 0.84; 95% CI 0.57 to 1.10).

The proportion of patients discharged during the day was significantly higher in the additional training group using a simulation model compared to the standard training group (1 trial; 50 patients; additional training using a 24-hour simulation model (100%) compared to standard training 15/26 (57.7%); RR 1.71; 95% CI 1.23 to 2.37). None of the trials reported on trainee satisfaction. Operative performance was significantly better in the additional training group using a simulation model compared to the standard training group (seven trials; 249 trainees; SMD 0.84; 95% CI 0.57 to 1.10).

Conclusion

None of the trials reported on trainee satisfaction. Operative performance was significantly better in the additional training group using a simulation model compared to the standard training group (seven trials; 249 trainees; SMD 0.84; 95% CI 0.57 to 1.10). None of the trials reported on trainee satisfaction.

Operative performance was significantly better in the additional training group using a simulation model compared to the standard training group (seven trials; 249 trainees; SMD 0.84; 95% CI 0.57 to 1.10).

None of the trials compared training using a simulation model versus training using an animal model or versus different training methods using a simulation model.

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