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01.10.2013 | Original Article | Ausgabe 10/2013

International Urogynecology Journal 10/2013

Warm-up on a simulator improves residents’ performance in laparoscopic surgery: a randomized trial

Zeitschrift:
International Urogynecology Journal > Ausgabe 10/2013
Autoren:
Chi Chiung Grace Chen, Isabel C. Green, Jorie M. Colbert-Getz, Kimberly Steele, Betty Chou, Shari M. Lawson, Dana K. Andersen, Andrew J. Satin
Wichtige Hinweise
This paper was presented at the 2012 APGO/CREOG Annual Meeting, Orlando, FL on March 8th 2012.

Abstract

Introduction and hypothesis

Our aim was to assess the impact of immediate preoperative laparoscopic warm-up using a simulator on intraoperative laparoscopic performance by gynecologic residents.

Methods

Eligible laparoscopic cases performed for benign, gynecologic indications were randomized to be performed with or without immediate preoperative warm-up. Residents randomized to warm-up performed a brief set of standardized exercises on a laparoscopic trainer immediately before surgery. Intraoperative performance was scored using previously validated global rating scales. Assessment was made immediately after surgery by attending faculty who were blinded to the warm-up randomization.

Results

We randomized 237 residents to 47 minor laparoscopic cases (adnexal/ tubal surgery) and 44 to major laparoscopic cases (hysterectomy). Overall, attendings rated upper-level resident performances (postgraduate year [PGY-3, 4]) significantly higher on global rating scales than lower-level resident performances (PGY-1, 2). Residents who performed warm-up exercises prior to surgery were rated significantly higher on all subscales within each global rating scale, irrespective of the difficulty of the surgery. Most residents felt that performing warm-up exercises helped their intraoperative performances.

Conclusion

Performing a brief warm-up exercise before a major or minor laparoscopic procedure significantly improved the intraoperative performance of residents irrespective of the difficulty of the case.

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