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01-03-2018 | ORIGINAL ARTICLE

Conception of the Lübeck Toolbox curriculum for basic minimally invasive surgery skills

Authors: Tilman Laubert, Hamed Esnaashari, Paul Auerswald, Anna Höfer, Michael Thomaschewski, Hans-Peter Bruch, Tobias Keck, Claudia Benecke

Published in: Langenbeck's Archives of Surgery | Issue 2/2018

Abstract

Purpose

Difficulties at the beginning of the learning curve in minimally invasive surgery (MIS) can well be overcome by simulation outside the operating room. Despite a great number of available devices, standardized, structured, and validated training curricula for video simulators are scarce.

Methods

The Lübeck Toolbox (LTB) video trainer provides six training modules and online video tutorials. Proficiency levels for the tasks were defined by performance analysis of MIS experts (n = 15). Mean values of the best performed repetitions were set as benchmarks for a validation study with n = 30 MIS novices and the learning curves calculated. The novices performed a cholecystectomy on a pig organ model before and after the curriculum which were analyzed using the GOALS score.

Results

Benchmarks defined by expert performance for the task Nos. 1 to 6 were 72 s (± 8) (Pack Your Luggage), 49 s (± 9) (Weaving), 66 s (± 10) (Chinese Jump Rope), 89 s (± 28) (Triangle Cut), 138 s (± 44) (Hammer Cut), and 98 (± 22) (Suturing). The median numbers of required repetitions by the novices to reach the proficiency level were n = 42 (7–80), n = 26 (9–55), n = 32 (14–77), n = 44 (15–59), n = 19 (6–68), and n = 26 (15–60). These values were all located at the beginning of the plateau phase of the learning curves. GOALS score improved significantly after completion of the curriculum (18.0 (± 2.6) vs. 10.9 (± 1.6), p < 0.0001).

Conclusion

The LTB curriculum constitutes a new highly standardized and proficiency level-based training program for basic skills in MIS. Transferability of the task content to a (sub)-realistic environment could be demonstrated. Still, future trials will have to further validate the effectiveness of the LTB curriculum.

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Title: Conception of the Lübeck Toolbox curriculum for basic minimally invasive surgery skills
Authors: Tilman Laubert
Hamed Esnaashari
Paul Auerswald
Anna Höfer
Michael Thomaschewski
Hans-Peter Bruch
Tobias Keck
Claudia Benecke
Publication date: 01-03-2018
Publisher: Springer Berlin Heidelberg
Published in: Langenbeck's Archives of Surgery / Issue 2/2018
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-017-1642-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Conception of the Lübeck Toolbox curriculum for basic minimally invasive surgery skills

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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