Effect of Preoperative Warm-up Exercise Before Laparoscopic Gynecological Surgery: A Randomized Trial

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• 作者：Stephan Polterauer ; MD^* ; ^&dagger ; ; ^{stephan.polterauer@meduniwien.ac.at" class="auth_mail" title="E-mail the corresponding author} ; Heinrich Husslein ; MD^* ; Marlene Kranawetter ; MD^* ; Richard Schwameis ; MD^* ; Alexander Reinthaller ; MD^* ; ^&dagger ; ; Georg Heinze ; PhD^&Dagger ; ; Christoph Grimm ; MD^*
• 关键词：computer-simulation ; laparoscopic training ; salpingo-oophorectomy ; training ; warm-up
• 刊名：Journal of Surgical Education
• 出版年：2016
• 出版时间：May-June 2016
• 年：2016
• 卷：73
• 期：3
• 页码：429-432
• 全文大小：157 K

文摘

Laparoscopic surgical procedures require a high level of cognitive and psychomotoric skills. Thus, effective training methods to acquire an adequate level of expertise are crucial. The aim of this study was to investigate the effect of preoperative warm up training on surgeon׳s performance during gynecologic laparoscopic surgery.

Materials and Methods

In this randomized controlled trial, surgeons performed a preoperative warm up training using a virtual reality simulator before laparoscopic unilateral salpingo-oophorectomy. Serving as their own controls, each subject performed 2 pairs of laparoscopic cases, each pair consisting of 1 case with and 1 without warm up before surgery. Surgeries were videotaped and psychomotoric skills were rated using objective structured assessment of technical skills (OSATS) and the generic error rating tool by a masked observer. Perioperative complications were assessed. Statistical analysis was performed using a mixed model, and mean OSATS scores were compared between both the groups.

Results

In total, data of 10 surgeons and 17 surgeries were available for analysis. No differences between educational level and surgical experiences were observed between the groups. Mean standard error psychomotoric and task-specific OSATS scores of 19.8 (1.7) and 3.7 (0.2) were observed in the warm up group compared with 18.6 (1.7) and 3.8 (0.2) in the no warm up group, respectively (p = 0.51 and p = 0.29). Using generic error rating tool, the total number of errors was 8.75 (2.15) in the warm up group compared with 10.8 (2.18) in the no warm-up group (p = 0.53). Perioperative complications and operating time did not differ between both the groups.

Discussion

The present study suggests that warm-up before laparoscopic salpingo-oophorectomy does not increase psychomotoric skills during surgery. Moreover, it does not influence operating time and complication rates.

(Medical University of Vienna-IRB approval number, 1072/2011, ClinicalTrials.gov number, NCT01712607)