The pelvitrainer for training in laparoscopic surgery - A prospective, multicenter, interdisciplinary study: Experimental research

Johannes Ackermann; Julia Pahls; Jorun Baumann; Carolin Spüntrup; Bernd Holthaus; Günter Noé; Michael Anapolski; Ivo Meinhold-Heerlein; Antonio Simone Laganà; Göntje Peters; Julian Pape; Damaris Willer; Anna Maria Westermann; Veronika Günther; Nicolai Maass; Liselotte Mettler; Ibrahim Alkatout

doi:10.1016/j.ijsu.2022.106604

The pelvitrainer for training in laparoscopic surgery - A prospective, multicenter, interdisciplinary study: Experimental research

Int J Surg. 2022 May:101:106604. doi: 10.1016/j.ijsu.2022.106604. Epub 2022 Apr 7.

Authors

Johannes Ackermann¹, Julia Pahls², Jorun Baumann³, Carolin Spüntrup⁴, Bernd Holthaus⁵, Günter Noé⁶, Michael Anapolski⁷, Ivo Meinhold-Heerlein⁸, Antonio Simone Laganà⁹, Göntje Peters¹⁰, Julian Pape¹¹, Damaris Willer¹², Anna Maria Westermann¹³, Veronika Günther¹⁴, Nicolai Maass¹⁵, Liselotte Mettler¹⁶, Ibrahim Alkatout¹⁷

Affiliations

¹ Kiel School of Gynaecological Endoscopy, Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (House C), 24105, Kiel, Germany. Electronic address: kiel.school@uksh.de.
² Kiel School of Gynaecological Endoscopy, Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (House C), 24105, Kiel, Germany. Electronic address: Julia.Pahls@uksh.de.
³ Kiel School of Gynaecological Endoscopy, Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (House C), 24105, Kiel, Germany; Department of Obstetrics and Gynecology, University Hospital of Giessen, Klinikstr. 33, 35392, Gießen, Germany. Electronic address: jorun.baumann@gyn.med.uni-giessen.de.
⁴ Pelvic School Saarbrücken, Hohe Wacht 77, 66119, Saarbrücken, Germany. Electronic address: carolin.banerjee@gmx.de.
⁵ Clinic of Obstetrics and Gynecology, St. Elisabeth Hospital, Damme, Germany. Electronic address: b.holthaus@t-online.de.
⁶ Department of Obstetrics and Gynecology, University Witten/Herdecke, Rheinland Klinikum Dormagen, Dr.-Geldmacher-Strasse 20, 41540, Dormagen, Germany. Electronic address: karl-guenter.noe@kkh-ne.de.
⁷ Department of Obstetrics and Gynecology, University Witten/Herdecke, Rheinland Klinikum Dormagen, Dr.-Geldmacher-Strasse 20, 41540, Dormagen, Germany. Electronic address: michael.anapolski@kkh-ne.de.
⁸ Department of Obstetrics and Gynecology, University Hospital of Giessen, Klinikstr. 33, 35392, Gießen, Germany. Electronic address: ivo.meinhold-heerlein@gyn.med.uni-giessen.de.
⁹ Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy. Electronic address: antoniosimone.lagana@uninsubria.it.
¹⁰ Kiel School of Gynaecological Endoscopy, Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (House C), 24105, Kiel, Germany. Electronic address: Goentje.Peters@uksh.de.
¹¹ Kiel School of Gynaecological Endoscopy, Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (House C), 24105, Kiel, Germany. Electronic address: julian.m.pape@gmail.com.
¹² Kiel School of Gynaecological Endoscopy, Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (House C), 24105, Kiel, Germany. Electronic address: Damaris.Willer@uksh.de.
¹³ Kiel School of Gynaecological Endoscopy, Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (House C), 24105, Kiel, Germany. Electronic address: AnnaMaria.Westermann@uksh.de.
¹⁴ Kiel School of Gynaecological Endoscopy, Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (House C), 24105, Kiel, Germany. Electronic address: Veronika.Guenther@uksh.de.
¹⁵ Kiel School of Gynaecological Endoscopy, Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (House C), 24105, Kiel, Germany. Electronic address: Nicolai.Maass@uksh.de.
¹⁶ Kiel School of Gynaecological Endoscopy, Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (House C), 24105, Kiel, Germany. Electronic address: profmettler@gmx.de.
¹⁷ Kiel School of Gynaecological Endoscopy, Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3 (House C), 24105, Kiel, Germany. Electronic address: Ibrahim.Alkatout@uksh.de.

PMID: 35398529
DOI: 10.1016/j.ijsu.2022.106604

Abstract

Background: Minimally invasive surgical procedures have a flat learning curve, especially in the initial period of a surgeon's training. Pelvitrainers enable the prospective surgeon to drill the surgical technique, including camera navigation, instrument manipulation, and the individual steps of the operation, on a model rather than a patient. Integrating the pelvitrainer into standardized surgical training programs is challenging, but would be essential to achieve optimum effects of long duration in surgical education.

Material and methods: The pelvitrainer Realsimulator 2.0 (Endodevelop) was evaluated in 16 standardized training courses (at three training centers) of the German Working Group for Gynecological Endoscopy (AGE e.V.) from 2017 to 2020, The training concept was implemented and evaluated in a prospective, multicenter, interdisciplinary, multinational setting.

Results: One hundred and eighty of 206 physicians (response rate 87.4%) completed the multi-stage training concept successfully. A significant (p < 0.001) objective improvement (positive learning curve) was observed for all exercises on the pelvitrainer. The trainer's subjective evaluation revealed positive ratings for design (median 82%, IQR 71-91%), camera navigation (87%, IQR 76-95%), and instrument manipulation (median 87%, IQR 77-94%). A follow-up survey performed six months after the course confirmed its sustainable and high benefits in clinical routine (median 82%, IQR 70-97%).

Conclusion: The present investigation proved the high educational value of pelvitrainers, which can be enhanced by using a structured training concept. The benefit of training courses for health care justifies their incorporation into a standardized training curriculum. The completion of such training courses should be regarded as a prerequisite for a doctor to qualify as an independent surgeon.

Keywords: Laparoscopic surgery; Laparoscopic training; Learning curve; Pelvitrainer; Surgical education.

Publication types

Multicenter Study

MeSH terms

Clinical Competence
Curriculum
Humans
Interdisciplinary Studies
Laparoscopy* / education
Learning Curve
Prospective Studies