Use of Box Simulators for the Improvement of Laparoscopic Skills in the Field of Gynaecology

Abstract

Objective: To determine the use of box simulators to improve laparoscopic skills in the field of gynaecology.
Study design
Methodology:: It is a prospective, blinded, comparative and quantitative study was conducted in gynae unit-I, Holy Family hospital, Rawalpindi Medical University, Rawalpindi from March 2017 – March 2019. Six hands-on training workshops were conducted. Each workshop was of twelve working hours. The participants were divided into two groups: one group went to laparoscopic theatre and assisted the surgeons, the second group went to skill lab and performed the following six tasks on box trainers; camera navigation, instrument navigation, peg transfer, ball transfer, pattern cutting and suture drill. They were given 60 minutes to practice each task. Each batch has the equal number of participants either novice or already performing the diagnostic procedures. On day two, the participants performed the above-mentioned tasks on the virtual reality trainer. The data were collected on the structured proforma.
Results: The group who have spent the first day in skill lab performed the same tasks on virtual reality trainer in less time and more accurately as compared to the group who had spent the day one in theatre. 88% found the exercises done on box trainers very useful. Although 64% wanted increase in training time on the box simulators.
Conclusion: The box trainer is an effective low- cost solution to improve the laparoscopic skills in a low resource country like Pakistan.