Abstract
Background Simulation-based practice has become increasingly important in minimally invasive
surgery (MIS) training. Nevertheless, personnel resources for demonstration and mentoring
simulation-based practice are limited. Video tutorials could be a useful tool to overcome
this dilemma. However, the effect of video tutorials on MIS training and improvement
of MIS skills is unclear.
Methods A prospective randomised trial (n = 24 MIS novices) was conducted. A video-trainer
with three different tasks (#1 – 3) was used for standardised goal-directed MIS training.
The subjects were randomised to two groups with standard instructional videos (group
A, n = 12) versus comprehensive video tutorials for each training task watched at
specific times of repetition (group B, n = 12). Performance was analysed using the
MISTELS score. At the beginning and following the curriculum, an MIS cholecystectomy
(CHE) was performed on a porcine organ model and analysed using the GOALS score. After
18 weeks, participants performed 10 repetitions of tasks #1 – 3 for follow-up analysis.
Results More participants completed tasks #1 and #2 in group B (83.3 and 75%) than in group
A (66.7 and 50%, ns). For task #2, there was a significant improvement in precision
in group B (p < 0.001). For the entire cohort, the GOALS-Scores were 12.9 before and
18.9 after the curriculum (p < 0.001), with no significant difference between groups.
Upon follow-up, 84.2% (task#1), 26.3% (task#2) and 100% (task#3) of MIS novices were
able to reach the defined goals (A vs. B ns). There was a trend for a better MISTELS
score in group B upon follow-up.
Conclusions Standardised comprehensive video tutorials watched frequently throughout practice
can significantly improve precision in MIC training. This aspect should be incorporated
in MIS training.
Key words
laparoscopy - MISTELS - Lübeck Toolbox - simulation training - video tutorials
