title: Training Significantly Improves Fetoscopy Performance: A Pilot Randomized Controlled Trial.
abstract: BackgroundImplementation of complex fetoscopic procedures that included intracorporeal suturing has been limited due to technical difficulties that might be surmounted with adequate training. Evaluating the impact of laparoscopic or fetoscopic training on fetoscopic performance was the aim of this study.MethodsTo evaluate fetoscopic performance after either laparoscopic or fetoscopic training, subjects were asked to perform four surgeon's square knots fetoscopically prior and post 2 hours of hands-on training. All subjects were medical students and novice in laparoscopic and fetoscopic interventions. Total time, knot stability (evaluated via tensiometer), suture accuracy, knot quality, and fetoscopic performance were assessed.ResultsForty-six subjects were included in the study; after simple randomization, 24 were trained fetoscopically and 22 laparoscopically. Both groups had comparable baseline characteristics and improved after training significantly regarding all aspects assessed in this study. Subjects who trained fetoscopically were superior in terms of suturing and knot-tying performance.ConclusionTraining significantly improves fetoscopic performance and may indeed be the keystone for future complex fetoscopic interventions. It seems advisable to train rather fetoscopically than laparoscopically resulting in higher suture and knot-tying quality.
authors.affiliation: Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Mietzsch
authors.affiliation: Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Boettcher
authors.affiliation: Hamburg University of Technology, Hamburg, Germany.
authors.forename: Sisi
authors.initials: S
authors.lastname: Yang
authors.affiliation: Hamburg University of Technology, Hamburg, Germany.
authors.forename: Pierre
authors.initials: P
authors.lastname: Chantereau
authors.affiliation: Department of Surgery, Section of Pediatric Surgery, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Philip
authors.initials: P
authors.lastname: Romero
authors.affiliation: Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Bergholz
authors.affiliation: Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Konrad
authors.initials: K
authors.lastname: Reinshagen
authors.affiliation: Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Boettcher
mesh_terms: D002983:Clinical Competence; D005332:Fetoscopy / Q000193:education*; D006801:Humans; D010535:Laparoscopy / Q000193:education*; D010865:Pilot Projects; D013337:Students, Medical; D013536:Suture Techniques / Q000193:education