title: A warm-up laparoscopic exercise improves the subsequent laparoscopic performance of Ob-Gyn residents: a low-cost laparoscopic trainer.
abstract: BACKGROUND
  Residents traditionally acquire surgical skills through on-the-job training. Minimally invasive laparoscopic techniques present additional demands to master complex surgical procedures in a remote 2-dimensional venue. We examined the effectiveness of a brief warm-up laparoscopic simulation toward improving operative proficiency.
  
  
  METHODS
  Using a "Poor-Man's Laparoscopy Simulator," 12 Ob/Gyn residents and 12 medical students were allocated 10 minutes to transfer 30 tablets with a 5-mm grasper from point A to point B via laparoscopic visualization in a warm-up exercise. Participants repeated the exercise following a 5-minute pause. Mean scores, expressed in seconds/tablet, and overall improvement (percentage difference between warm-up and follow-up) were analyzed according to postgraduate standing (PGY14), dexterity skills, and pertinent vocational activities.
  
  
  RESULTS
  Significant improvements were noted for both residents (+25%) and medical students (+29%), P<0.0001. Scores between the 2 groups, however, were not significant (P=0.677). Proficiency was not influenced by PGY standing. Interestingly, the best (8.73 sec/pill) and the worst (25 sec/pill) scores were attained by a medical student and a chief resident, respectively, suggesting the contribution of individual aptitude.
  
  
  CONCLUSIONS
  A brief warm-up exercise before an actual laparoscopic surgical procedure significantly improves subsequent laparoscopic performance.
authors.affiliation: Department of Obstetrics and Gynecology, The Brooklyn Hospital Center, Brooklyn, New York 11209, USA.
authors.forename: Ann T
authors.initials: AT
authors.lastname: Do
authors.forename: Michael F
authors.initials: MF
authors.lastname: Cabbad
authors.forename: Angela
authors.initials: A
authors.lastname: Kerr
authors.forename: Eli
authors.initials: E
authors.lastname: Serur
authors.forename: Robert R
authors.initials: RR
authors.lastname: Robertazzi
authors.forename: Miljan R
authors.initials: MR
authors.lastname: Stankovic
mesh_terms: D002983:Clinical Competence; D006176:Gynecology / Q000193:education*; D007396:Internship and Residency; D010535:Laparoscopy / Q000592:standards*; D009774:Obstetrics / Q000193:education*; D010865:Pilot Projects; D013337:Students, Medical; D013664:Teaching Materials / Q000191:economics