title: Novice surgeons versus experienced surgeons in laparoendoscopic single-site (LESS) surgery: a comparison of performances in a surgical simulator.
abstract: BACKGROUND
  During the past years, there has been increasing interest in simulation-based training of technical skills especially in laparoscopy. The purpose of this study was to compare the performances of novice and experienced laparoscopic surgeons on a LESS simulator.
  
  
  METHODS
  The study recruited 20 surgeons classified into two groups: group NS consisted of ten residents without any laparoscopic experience, and group ES consisted of ten surgeons with experience in conventional laparoscopy (performed >90 laparoscopic cholecystectomies) but without any experience in LESS surgery. Both groups completed a mini-trainee course that included four repetitions of a standardized task of circle pattern cutting (CIRCLE). Time, path length, and economy of movement were measured and compared.
  
  
  RESULTS
  Group ES presented significantly better time scores than group NS in all four repetitions. Economy of movement did not differ significantly between the two groups, whereas path length was shorter for beginners at the forth effort. Moreover, group ES failed to improve path length and economy of movement scores, whereas group NS improved their performance significantly in these parameters.
  
  
  CONCLUSIONS
  It seems that previous laparoscopic experience in conventional laparoscopy may not necessarily be an advantage in all parameters of LESS surgery and the learning process can be longer than expected even for experienced surgeons.
authors.affiliation: First Department of Propaedeutic Surgery, Hippokration Hospital, Athens Medical School Greece, 114 Queen's Sofia Avenue, Athens Medical School Greece, 115 27, Athens, Greece. leonalevizos@gmail.com.
authors.forename: Leonidas
authors.initials: L
authors.lastname: Alevizos
authors.affiliation: Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: Willem
authors.initials: W
authors.lastname: Brinkman
authors.affiliation: Centre Hospitalier Intercommunal, Poissy, France.
authors.forename: Abe
authors.initials: A
authors.lastname: Fingerhut
authors.affiliation: Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: Jack
authors.initials: J
authors.lastname: Jakimowicz
authors.affiliation: First Department of Propaedeutic Surgery, Hippokration Hospital, Athens Medical School Greece, 114 Queen's Sofia Avenue, Athens Medical School Greece, 115 27, Athens, Greece.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Leandros
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003198:Computer Simulation; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy / Q000193:education* / Q000379:methods; D008297:Male; D008348:Manikins