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Assessment of the learning curve for the novel transanal minimally invasive surgery simulator model

  • 2021 SAGES Oral
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Transanal minimally invasive surgery (TAMIS) is technically demanding and requires extensive training. We developed the TAMIS simulator model by remodeling an existing laparoscopic training system to educate trainees and analyzed their learning curves.

Methods

Between March 2020 and June 2020, 12 trainees performed TAMIS simulator training sessions. The total operative time, including specimen removal and wound closure, was recorded. The wound closure and specimen quality, trainee self-confidence, and supervisor evaluation of technical performance were documented. A moving average was used to analyze the number of training sessions required to stabilize the procedure time, while a cumulative sum analysis was performed to identify that required to reach proficiency with each item.

Results

Each trainee completed 20 TAMIS simulator training sessions. The median total procedure time was 13 min (range, 4–60 min), which stabilized after 15 training sessions. The median times for specimen removal and wound closure were 3 min (range, 1–18 min) and 10 min (range, 2–50 min), respectively, which stabilized after 7 and 15 training sessions, respectively. The mean specimen and wound closure quality scores were 2.9 ± 0.9 (on a scale from 1 to 4) and 2.3 ± 1.1 (on a scale from 1 to 4), respectively, competencies in which were achieved after 16 and 20 training sessions, respectively. The mean trainee self-confidence and supervisor evaluation of technical performance scores were 2.4 ± 1.2 (on a scale from 1 to 5) and 2.7 ± 1.2 (on a scale from 1 to 5), respectively, competencies in which were achieved after 20 and 17 training sessions, respectively.

Conclusion

Trainees required 15 training sessions to stabilize the procedure time and 16–20 training sessions to demonstrate competencies with the TAMIS simulator model. We expect this simulator model may help surgeons more rapidly acquire the skills required for TAMIS.

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Acknowledgements

This work was supported by the Research Core Center in National Cancer Center Korea. The laparoscopic training system mainframe for the simulator body was supplied by Applied Medical Resources Corporation, Rancho Santa Margarita, CA, USA.

Funding

This project was supported by a grant from the National Cancer Center, Korea (Grant Number NCC-1810190).

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Author notes

  1. Sung Sil Park and Sung Chan Park have equally contributed to this work.

Authors and Affiliations

  1. Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi, 10408, South Korea

    Sung Sil Park, Sung Chan Park, Jae Hwan Oh & Dae Kyung Sohn

  2. Division of Convergence Technology, Research Institute and Hospital, National Cancer Center, Goyang, South Korea

    Hongrae Kim & Dae Kyung Sohn

  3. Biostatistics Collaboration Team, Research Institute and Hospital, National Cancer Center, Goyang, South Korea

    Dong-Eun Lee

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  1. Sung Sil Park
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  2. Sung Chan Park
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  3. Hongrae Kim
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  4. Dong-Eun Lee
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  5. Jae Hwan Oh
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  6. Dae Kyung Sohn
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Corresponding author

Correspondence to Dae Kyung Sohn.

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Disclosures

Dr. Sung Sil Park, Dr. Hongrae Kim, Dong-Eun Lee, Dr. Sung Chan Park, Dr. Jae Hwan Oh, and Dr. Dae Kyung Sohn have no conflicts of interest or financial ties to disclose.

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Park, S.S., Park, S.C., Kim, H. et al. Assessment of the learning curve for the novel transanal minimally invasive surgery simulator model. Surg Endosc 36, 6260–6270 (2022). https://doi.org/10.1007/s00464-022-09214-w

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  • DOI: https://doi.org/10.1007/s00464-022-09214-w

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