Using three-dimensional laparoscopy as a novel training tool for novice trainees compared with two-dimensional laparoscopy.

BACKGROUND: Laparoscopic skills training is an essential component of general surgery training. This study proposes the use of three-dimensional (3D) laparoscopy as the initial training tool for beginners to shorten the learning curve. METHODS: This study evaluates the surgical performance and subjective experience of junior and senior trainees with 3D versus two-dimensional laparoscopy. Peg transfer task was used as the objective time measurement. A subjective evaluation of the 2 systems using a questionnaire was also used. RESULTS: The mean difference in the juniors was 16.33 seconds, while in the seniors it was only 3.46 seconds (P = .036). The time difference between groups was much smaller in the 3D than the two-dimensional (P = .14 vs .02) laparoscopy. In the subjective evaluation, the novice group also scored significantly higher for the 3D system in the bimanual dexterity category (P = .004, .007). CONCLUSION: Our study demonstrates the feasibility of using 3D laparoscopy for laparoscopic skills training in novices.

Quantifying surgeon's contribution to team effectiveness on a mixed team with a junior surgeon.

BACKGROUND: A surgical team often consists of an experienced surgeon and surgeons in training. This project quantified the contribution of the experienced surgeon to the teamwork in a team comprised of 1 experienced and 1 novice surgeon (Mixed Team). METHODS: An experienced and a novice surgeon in a Mixed Team were required to complete a peg transportation task and an intracorporeal suture task collaboratively. Tasks were evaluated by a summative score (up to 100 points) that was calculated on task speed and accuracy. Performances of 24 Mixed Teams were compared to 24 Novice Teams (each composed of 2 novices) and 8 Expert Teams (each composed of 2 experienced surgeons). RESULTS: The Mixed Teams performed better (67.6 points) than the Novice Teams (51.3; P < .001) but worse than the Expert Teams (88.3; P < .001). When examining individual performance in the Mixed Teams, we observed that experienced surgeons maintained their superior performance like they did in the Expert Teams (P = .153). Novices in the Mixed Teams, however, showed markedly better performances than they did in the Novice Teams (P = .024). CONCLUSION: Instant guidance and instruction from experienced surgeons inspire novices' performance, providing a foundation for surgical teamwork effectiveness.