Effect of three training programs on surgical performance in single-port laparoscopic surgery

Objective:The aim of this study was to evaluate the effect of three training methodologies on the acquisition of psychomotor skills for laparoendoscopic single-site surgery (LESS), using straight and articulating instruments.Methods: A prospective study was conducted with subjects randomly divided into three groups, who performed a specific training for 12 days using three laparoscopic tasks in a laparoscopic simulator.Group-A trained in conventional laparoscopy setting using straight instruments and in LESS setting using both straight and articulating instruments.Group-B trained in LESS setting using straight and articulating instruments, whereas Group-C trained in LESS setting using articulating instruments.Participants' performance was recorded with a video-tracking system and evaluated with 12 motion analysis parameters (MAPs).Results: All groups obtained significant differences in their performance in most of the MAPs.Group-C showed an improvement in nine MAPs, with a high level of technical competence.Group-A presented a marked improvement in bimanual dexterity skills.Conclusions: Training in LESS surgery using articulating laparoscopic instruments improves the quality of skills and allows smoother learning curves.