LAUSR

OBJECTIVE: To determine the efficacy of a two-day intensive surgical boot camp in improving laparoscopic suturing performance among REI fellows. DESIGN: Prospective comparison of REI fellow performance on structured laparoscopic suturing drills before and after two days of intensive training using laparoscopic simulators. MATERIALS AND METHODS: 41 REI fellows attended a national surgical skills boot camp in January 2017 focused on techniques in minimally invasive reproductive surgery. The two-day course included a 15-minute lecture and video demonstration of laparoscopic suturing and knot tying as well as a total of 60-minutes of guided practice using laparoscopic simulators (dry labs) and 90-minutes of guided practice using cadaveric models (wet labs). Each fellow was asked to perform three structured tasks modified from the Fundamentals of Laparoscopic Suturing (FLS) curriculum, including: 1) placement of three running stiches, 2) an extracorporeal (EC) knot, and 3) an intracorporeal (IC) knot. Mean times for each fellow were compared before (pre-test) and after the guided instruction (post-test) using paired t-tests RESULTS: All 41 fellows completed the pre-test; 3 fellows failed to complete the post-test. The results of the timed tests are showed in Table 1 with data presented as mean + standard deviation in minutes. Table 1: Timed tasks in minutes Task Pre-test (n=41) Post-test (n=38) Delta P-value Running 4.3 +/1.7 2.8 +/1.5 -1.5 +/1.8 <0.01 EC knot 5.8 +/1.8 3.8 +/1.8 -2.0 +/1.6 <0.01 IC knot 7.9 +/2.9 4.9 +/2.6 -3.0 +.2.6 <0.01 CONCLUSIONS: Focused, short-term training using pelvic simulators can improve laparoscopic suturing skill in REI fellows. Given inconsistent and sometimes limited surgical training in REI fellowship programs, a surgical boot camp may provide a means by which fellows can obtain and retain the requisite skill set for reproductive surgery.