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This prospective randomized study aims for determination whether focused simulator based laparoscopic camera training in novices can improve camera performance in an actual clinical situations in the same manner as traditional training in the OR does, especially considering efficient use of training time.
Medical students in their final years without any significant experience in handling an angled laparoscopic camera participate in the study and perform a camera guidance test in surgery. The participants are then randomized in two groups to receive either a simulator based or traditional in theatre training during three weeks. The camera test will be repeated, while both tests are going to be recorded. Videos of 14 camera tests carried out by laparoscopic experts are taped as well.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Operating room training | Active Comparator |
| |
| Skills lab training | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Training on laparoscopic simulator in skills lab | Behavioral | Laparoscopic camera training in a skills lab following training protocol for a total of 6 hours during 3 weeks. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Progress of skills shown in test regarding target centring as assessed by rating scale | Students are sent to the OR to do two camera assessment tests involving a standardized set of tasks they had to accomplish operation. They had to center and hold for 5 seconds the following positions/organs and had to maintain the correct horizontal alignment during camera movement: 1. Left abdominal wall, 2. Descending colon, 3. Right lobe of liver, 4. Sigmoid colon 5. Caecum 6. Pelvis 7. Trocar entry site in the upper left quadrant 8. Desc. Colon. This assessment was video-taped. A rating scale quantifying target centring was used. | After 3 weeks of individual training |
| Measure | Description | Time Frame |
|---|---|---|
| Total time effort spend for respective training time | Total time effort for OR group was defined as time used from receiving pager call (to go to OR) to leaving OR. Time effort for Skillslab group was defined as total time spend in Skillslab. | During 3 weeks of individual training |
| Progress of time to completion of test |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Florian M Franzeck, cand. med. | University of Zurich, Faculty of Medicine | Principal Investigator |
| Dieter Hahnloser, MD | University Hospital of Zurich, Departement of Visceral and Transplantation Surgery | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospital of Zurich | Zurich | 8091 | Switzerland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21853391 | Derived | Franzeck FM, Rosenthal R, Muller MK, Nocito A, Wittich F, Maurus C, Dindo D, Clavien PA, Hahnloser D. Prospective randomized controlled trial of simulator-based versus traditional in-surgery laparoscopic camera navigation training. Surg Endosc. 2012 Jan;26(1):235-41. doi: 10.1007/s00464-011-1860-5. Epub 2011 Aug 19. |
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| Training at actual laparoscopic surgery | Behavioral | Assisting at 6 laparoscopic surgeries navigating the camera during 3 weeks |
|
| Technical instruction | Behavioral | Technical instruction on proper handling of an angled laparoscope before randomization for 1 hour |
|
| After 3 weeks of individual training |
| Progress of skills shown in test regarding horizon alignment as assessed by rating scale | Students are sent to the OR to do two camera assessment tests involving a standardized set of tasks they had to accomplish operation. They had to center and hold for 5 seconds the following positions/organs and had to maintain the correct horizontal alignment during camera movement: 1. Left abdominal wall, 2. Descending colon, 3. Right lobe of liver, 4. Sigmoid colon 5. Caecum 6. Pelvis 7. Trocar entry site in the upper left quadrant 8. Desc. Colon. This assessment was video-taped. A rating scale quantifying horizon alignment was used. | After 3 weeks of individual training |