Evaluation of self-education training methods to learn laparoscopic skills – randomized control test



Evaluation of two different self-educational modes (learning about video assistance compared to video-aid learning as well as operating node primer) on learning laparoscopic timing and incorporated knitting.

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Randomized control trial at the laparoscopic surgical training center, with 45 first year surgical students being pretended for dexterity. After self-education training for 90 minutes with either of the two methods (Group A: learning about video assistance, Group B: learning about video plus operating primer node points) participants had to make five laparoscopic entries. The number of nautical miles completed (maximum of five knots, counting knot, technical integrity and knitting time per knot) was assessed. The main result is a knotted score combining integrity of knot, technical competence and knitting time.


Group B (n = 23) involved a knot score which was significantly higher than Group A (n = 22) (53.3 ± 8.4 compared to 46.5 ± 13.6 points respectively, p = 0.016). The median knot time per completed knot was very different between Group B and Group A (308 s [100–1221] compared to 394 s [138–1397] respectively, p = 0.001). The number of completed knots showed a trend towards more knots reached in Group B (4.2 ± 1.2 compared to 3.55 ± 1.4 respectively, p = 0.075).


The use of a node point mains operation which emphasizes the essential steps of the procedure contributes to the success of laparoscopic learning skills such as caving and incorporation.


Providing an internship for laparoscopic surgical skills is a major challenge and is very important in any educational surgical residency program. In particular given the limited training opportunities in the operating room due to the restricted working hours and operating costs on its border, optimized teaching strategies for residents are required. Simulation-based training methods that support training and transferability training into the operating room were published. However, the teaching implementation strategies for simulation resident training are less well established. One possible option to learn learning by following video tutorials and practical training from the resident. An additional “step-by-step” additional teaching approach is available – instructions based on the philosophy of “mental training”, and the repeated key points of internalization of a procedure. While the actual mental training is required in the best way, “face-to-face” personal training and interoperability can be used on a daily basis.

The concept of a point nod which rejects a procedure in a limited number of essential key stages greatly improves the learning and internalization of laparoscopic skills. This concept emphasizes critical procedural steps and helps to envisage the procedure repeatedly.

The aim of this randomized control test was to assess the value of an additional “node point of operation” without the actual mental training in the self-learned learning process with laparoscopic growth and incorporeal knot.


Location and participants

This study was carried out by the Surgical Training Center. Due to the educational nature of the study, it was not necessary to evaluate the study protocol of the local ethics committee. Participants were first year medical students with no previous experience in surgical techniques and in particular with no previous laparoscopic skills.

Baseline assessment and precursor

In preparation, each participant received a video tutorial to make basic basics of laparoscope and incorporated knitting tranquility. Subsequently, participants had to respond to a standardized questionnaire about basic laparoscopy before the inclusion of studies. Less than 60% of the questions correctly answered were excluded from the study. After taking the study into account, two laparoscopic rehearsals were carried out based on laparoscopic incorporated simulation and knot in a black box trainer to assess manual dexterity and three-dimensional orientation ability. The first pre-simulated laparoscopic based simulation exercise required participants to contact 20 contact points of a 3-D model, with each ring point and ring that could be illuminated by LEDs having a diameter of 3 mm. Contact with the surrounding area was detected electronically as an error. For the second laparoscopic pre-simulation exercise was based on the needle participants to run horizontally through five openings in a wall with two instruments affixed. It was felt electronically that the wall was attracted to the needle or tools. In both exercises, the number of errors was set and the performance time required in seconds. Finally, participants had to perform a previous laparoscopic knot of incorporation in a maximum period of seven minutes according to the criteria mentioned below after viewing non-concentrated laparoscopic video and incorporated knitting.

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