Current Research Projects-Remote vs. proximal training of basic laproscopic training

The Future: Can We Teach Laparoscopy Remotely ?
Mohamad W. Salkini MD, Shane Johnson MD, Alyson Knapp BS, Allan Hamilton MD

Laparoscopic surgery is known to have a steep learning curve; and simulators are of proven value to transfer acquired skills into the operative setting. Telemedicine (TM) networks also proved their safety and efficacy, and despite their limited current applications, we believe that TM will have greater roles. We evaluated the use of telecommunication to assess remote versus proximal training of simulated laparoscopy.

Material and Methods: Sixteen laparoscopically naive medical students were randomized into two groups and trained by the same mentor to perform nine simulated laparoscopic tasks on laparoscopic trainers; and to repeat each one five times. The proximal group trained with the faculty mentor at their side viewing the monitor; demonstrating, and assisting them by direct manipulation of instruments. The remote group was trained at a distance employing the TM network with out any direct physical communication. The performance of the remote and proximal groups was statistically compared.

Results: The remote group demonstrated no significant differences in skill acquisition (66.6 +/-15 and 47.3 +/-10) seconds (P >0.02) or final performance speed from the proximal group. No difference in the total training time was observed between proximal and remote training 121 (89-142) VS 107(80-150) minute respectively (P<0.07)

Conclusion: Remote laparoscopic mentoring may be just as effective as the proximal training, suggesting that increased utilization of TM networks could dramatically improve access to laparoscopic mentoring.

View a PDF of the poster presented at Arizona Health Sciences Center Frontiers in Biomedical Research Poster Forum, Dec. 2006.