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The impact of intense laparoscopic skills training on the operative performance of urology residents.

Surgical training is undergoing more and more scrutiny and, with the advent of laparoscopic techniques, greater time is being spent in the statistical analysis and calculation of the surgeon’s ability. In this paper urology residents were randomised into two groups, after both groups had performed a porcine laparoscopic nephrectomy. One group then received 30 minutes of simulator training on a daily basis Escort Service Frankfurt for ten days. Following this period, a further porcine laparoscopic nephrectomy was performed by both groups. Surprisingly, according to the reported results, the group that had received simulator training performed no better than the control group at the second porcine laparoscopic nephrectomy. It was apparent that the trained group had become statistically more proficient at performing the simulator tasks. It is difficult to comprehend that, despite the fact that the urology residents were selected from years 3, 4 and 5, both groups of residents scored the same on baseline evaluation of their laparoscopic experience. Certainly possible sources of inaccuracy exist in the evaluation of the residents’ ability to perform the laparoscopic nephrectomy, as ‘expert’ assessors rated performances in different areas by rating as a mark out of five. It is difficult to ascertain what exactly the authors want to conclude from these results. They do indeed wish the practice of simulator training to continue but add the proviso that this should be supplemented with in-vivo training. The learning curve shall always exist and if the learning curve can be shortened by animal training then ultimately the patient will benefit. However, if simple techniques can be mastered on a simulator, then the benefits gained from animal training will be greater.