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Endo trainer box simulator as a tool for training and teaching in laparoscopic surgery

Methods

Endo trainer box simulator

This involves fiberglass console, such as human stem, hollow ring suitable for surgery anteroposterior movements and the space created in line with a pneumoperitoneal environment with access to a seam tray matrix for making procedures and sounds, at a similar depth. It also discovered that abdominal structures are in active tactile maneuvers. It has a distribution device and uses an infrared definition camera with a zoom and light source. LED strips are employed and external management and anatomical stem handling can be done using one of the portals. It can be connected to LED TV 19 ‘-85‘ or a series of video surgery to use cameras two or three dimensions.

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Laparoscopic portals are used to access the cavity through nails and tools. It provides management of the surgeon with the help of image movements, with appropriate lengths that allow triangulation and convergence for the adequate application of the expectations. A window is located in the “abdominal wall” of the simulator to complete a window under an illuminating vision. When it is removable it allows direct vision (three-dimensional) of the instruments on stage reverse movements exercises, resistance and resilience, ambidexterity and depth perspective (stereotaxy). This appliance has electrical and electronic components (a LED lamp set in the inner layer of the abdominal “peritoneum” of the mannequin, adequate filming and visibility of the film), electrical wiring, control cable, image stabilizer, current energy light switch, TV and camera).

Endo Trainer Box Simulator

With simple materials being used and specific devices to replace such as monitors and a generic one head allow an illustrative reduction of the cost compared to the standard laparoscopic trainer.

Laparoscopic standard trainer

The Standard Laparoscopic Trainer (SLT) used as standard equipment for comparison in the current study is A and Minimally Invasive. It is simple to set up and portable and has the original classic box there, and monitors 10 ″. Laparoscópacha port 6 at the device with interchangeable gromamanna (5 and 10 mm) and interior lighting. The instrument was designed for laparoscopic laden workstations for no one. The cost of this equipment, according to the Enterprise website.

Study design and participants

The study used SSL and was approved by the Ethics Committee. Each participant gave informed consent in writing after receiving an explanation of the study design. They were recruited among members of Surgeons and general surgical and urology residents from the institution.

The study was carried out using a design of randomized prospecting studies to assess its qualifications as a tool for training laparoscope skills, compared to the SLT. Therefore, a task was identified to assess laparoscopic skills, simulating the knotted funding operation (2 nautical miles in a diaphragmatic column and 4 knots in a gastric fund, corresponding to 6 laparoscopic mortgages).

Before completing the task on the simulators, the participants completed a questionnaire based on previous demographics and their laparoscopic experience, and received a general introduction to the simulators. They were given a standardized and thorough explanation of the task, including video presentation.

The task was to carry out 5 links at each surgical knot in a soft tissue pole, using a 2-0 silk thread, or to achieve a time limit of 18 minutes. Participants were assigned to complete the task using both and in a row. The startup order of simulators was randomized for each participant, using randomized software.

Prior to the testing period of surgical instruments at both simulators, each participant was given a 10 minute precursor period. When the task was completed, each participant carried out a self-assessment of the technical and technological profile of simulators and their ability to simulate laparoscopic procedures. On completion of the task, they responded to a questionnaire containing 10 items based on a 5-point Likert scale, with scores from 1 to 5: 1. Insufficient; 2. Regular; 3. Good; 4. Very good; 5. Excellent. The following items were analyzed: 1. Triangle of movements; 2. Resistance and resilience of thresholds; 3. Stereotaxy; 4. Ergonomics and location; 5. Fulcrum effect; 6. Visibility; 7. Design; 8. Technical resources for training; 9. Technology capacity; 10. Teaching. The overall score was defined as the median of 10 items.

Subsequently, surgeons on a progressive scale of skill and competence in video surgery were stratified from me, according to the time the task was completed: 1. Insufficient (execution 1, 2 or 3 knots in 18 minutes); 2. Regular (execution of 4 or 5 knots in 18 minutes); 3. Good (06 knots between 15 and 18 minutes); 4. Very good (06 knots between 12 and 15 minutes); 5. Excellent (execution 06 knots in less than 12 minutes).

Statistical analysis

Descriptive statistics included the calculation of the mean and standard deviation for the continuing variables, the median range and the interquartile range of imperative variables and absolute and relative frequencies of categorical variables. Comparisons were made between the two simulators for the scores of each section of the questionnaire using the signed phasing test. At each analysis, the level of significance was set at 0.05 (5%). it has been used to comply with the statistical procedures.

Results

A total of 37 participants were recruited with different levels of laparoscopic expertise for this study, aged 39,7 years, with a standard deviation of 11,3, of which 13 (35.14%) were general surgeons, 8 (21.63%) d) general surgical and urology residents, and surgeons in other surgical areas, who had at least 100 h practice (43.23%) were experts, showing the demographic characteristics of the participants of average age. the number of men (91.89%) and right hand (94.59%).

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