title: Training junior operative residents in laparoscopic suturing skills is feasible and efficacious.
abstract: BACKGROUND
  Laparoscopic suturing has been regarded as an advanced operative task, and courses to develop this skill are aimed at senior trainees and consultants. This study evaluates the role of laparoscopic suturing courses in the modern operative training curriculum.
  
  
  METHODS
  The performance of 9 senior operative trainees (course A) was compared to that of 14 junior operative trainees (course B) at identical, 2-day laparoscopic suturing courses. Pre- and post-course assessments measured time taken, dexterity, and quality for the placement of 1 intracorporeal suture on synthetic bowel. Post-course data was compared to the performance of a group of 6 experts.
  
  
  RESULTS
  The median number of laparoscopic procedures carried out unassisted was 130 for surgeons on course A, and 0 for those on course B. At the pre-course assessment, senior trainees (course A) were significantly faster, more dexterous, and had higher checklist scores then those on course B. Both groups had improved significantly by the end of each the course. Post-course comparison between the 2 groups showed equivalent path length and checklist scores, although group A remained faster (P = .003) and made fewer movements (P = .033). Senior trainees had similar performance data to the group of expert surgeons, although this was not the case for junior trainees.
  
  
  CONCLUSIONS
  Endoscopic suturing is a task that can be learned by operative trainees during short skills courses, regardless of baseline laparoscopic experience. Skills training in laparoscopic suturing should thus not be reserved only for those contemplating advanced laparoscopic operation.
authors.affiliation: Department of Surgical Oncology & Technology, Imperial College London, UK. rajesh.aggarwal@imperial.ac.uk
authors.forename: Rajesh
authors.initials: R
authors.lastname: Aggarwal
authors.forename: Julian
authors.initials: J
authors.lastname: Hance
authors.forename: Shabnam
authors.initials: S
authors.lastname: Undre
authors.forename: Joel
authors.initials: J
authors.lastname: Ratnasothy
authors.forename: Krishna
authors.initials: K
authors.lastname: Moorthy
authors.forename: Avril
authors.initials: A
authors.lastname: Chang
authors.forename: Ara
authors.initials: A
authors.lastname: Darzi
mesh_terms: D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy / Q000379:methods*; D013536:Suture Techniques / Q000193:education*