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CC BY 4.0 · Rev Bras Ginecol Obstet 2023; 45(10): e603-e608
DOI: 10.1055/s-0043-1772476
Original Article
Teaching and Training

Assessing Endoscopic Suture Performance of Gynecology and Obstetrics Residents Following Methodic Training

Avaliando a performance em sutura endoscópica de residentes de ginecologia e obstetrícia após treinamento metódico
Lucas Ribeiro Nogueira 
1   Universidade Federal do Ceará, Departamento de Saúde Materno Infantil, Fortaleza, CE, Brazil
,
Kathiane Augusto Lustosa 
1   Universidade Federal do Ceará, Departamento de Saúde Materno Infantil, Fortaleza, CE, Brazil
,
Larissa Almeida Oliveira Galindo 
1   Universidade Federal do Ceará, Departamento de Saúde Materno Infantil, Fortaleza, CE, Brazil
,
Stephany Ellen de Castro 
1   Universidade Federal do Ceará, Departamento de Saúde Materno Infantil, Fortaleza, CE, Brazil
,
Liz Rodrigues Picanço 
1   Universidade Federal do Ceará, Departamento de Saúde Materno Infantil, Fortaleza, CE, Brazil
,
Lucas Lima da Silva 
2   Universidade Federal do Cariri, Faculdade de Medicina, Juazeiro do Norte, CE, Brazil
,
Samuel Soares Coutinho 
1   Universidade Federal do Ceará, Departamento de Saúde Materno Infantil, Fortaleza, CE, Brazil
,
Leonardo Robson Pinheiro Sobreira Bezerra 
1   Universidade Federal do Ceará, Departamento de Saúde Materno Infantil, Fortaleza, CE, Brazil
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Abstract

Objective To evaluate the performance of residents in gynecology and obstetrics before and after practicing laparoscopic sutures, to establish when the training shows the best results, in addition to comparing whether being in different years of residency influences this progression.

Methods A prospective cohort study involving 32 medical residents evaluated with a pretest to establish their previous knowledge in laparoscopic suture. This test consisted of knotting two wires, one made of polypropylene and the other of polyglactin, with a blocking sequence of five semi-knots. We set a 30-minute limit to complete the task. Then, the residents held four training meetings, focusing on suture, Gladiator rule, knot, and symmetries, in addition to executing blocking sequences. A second test to establish progress was performed.

Results Regarding the time spent to make the stiches using polyglactin wire, a statistically significant time improvement (p < 0.01) was observed, with a 10.67-minute pretraining median (mean 12.24 minutes) and a 2.53-minute posttraining median (mean 3.25 minutes). Regarding the stitches with polypropylene wire, a statistically significant time improvement (p < 0.05) was also observed, with a 9.38-minute pretraining median (mean 15.43 minutes) and a 3.65-minute posttraining median (mean 4.54 minutes). A total of 64.2% of the residents had been able to make the knot with polypropylene previously. One hundred percent were able to complete the task in the posttest.

Conclusion Model training using the Gladiator rule for laparoscopic suture improves the knotting time with statistically similar performance, regardless of the year of residency, after systematic training.

Resumo

Objetivo Avaliar a performance de residentes em ginecologia e obstetrícia antes e depois de praticarem suturas laparoscópicas, com o intuito de estabelecer quando o treinamento mostra os melhores resultados, comparando se estar em diferentes da residência influencia essa progressão.

Métodos Um estudo coorte prospectivo envolvendo 32 médicos residentes avaliados com um teste pré-treinamento para avaliar seus conhecimentos prévios em sutura laparoscópica. Esse teste consistia em atar nós em dois fios, um de polipropileno e o outro de poliglactina, com uma sequencia de bloqueio de cinco seminós. Definiu-se um limite de 30 minutos para se completar a tarefa. Depois, os residentes tiveram quatro reuniões de treinamento, focadas em sutura, técnica da Regra do Gladiador, nós e simetria, executando, ainda, uma sequência de pontos. Um segundo teste foi feito para avaliar o progresso.

Resultados Com relação ao tempo para realizarem os pontos com fio de poliglactina, uma melhora de tempo estatisticamente significativa (p < 0.01) foi observada, com uma mediana de 10.67 minutos no pré-treinamento (média de 12.24 minutos) e uma mediana de 2.53 minutos no pós-treinamento (média de 3.25 minutos). Com relação ao fio de polipropileno, uma melhora de tempo estatisticamente significativa (p < 0.05) também foi observada, com uma mediana de pré-treinamento de 9.38 minutos (média de 15.43 minutos) e uma mediana de pós-treinamento de 3.65 minutos (média de 4.54 minutos). Um total de 64.2% dos residentes foram capazes de realizar os nós com polipropileno inicialmente. Cem por cento do residentes foram capazes de completar a tarefa no pós-teste.

Conclusão O modelo de treino usando a técnica da Regra do Gladiador para sutura laparoscópica melhora o tempo de atar nós com uma performance estatisticamente similar, não havendo diferenças quanto ao ano da residência, após treinamento sistematizado.

Keywords

suture techniques - medical education - in-service training - simulation training - laparoscopy

Palavras-chave

técnicas de sutura - educação médica - capacitação em serviço - treinamento por simulação - laparoscopia

Contributions

All of the authors contributed to the conception of project and data analysis and interpretation, the writing of the article and approved the final version to be published.




Publication History

Received: 04 October 2022

Accepted: 25 April 2023

Article published online:
09 November 2023

© 2023. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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