title: Simulation-based camera navigation training in laparoscopy-a randomized trial.
abstract: Inexperienced operating assistants are often tasked with the important role of handling camera navigation during laparoscopic surgery. Incorrect handling can lead to poor visualization, increased operating time, and frustration for the operating surgeon-all of which can compromise patient safety. The objectives of this trial were to examine how to train laparoscopic camera navigation and to explore the transfer of skills to the operating room.
  
  
  
  A randomized, single-center superiority trial with three groups: The first group practiced simulation-based camera navigation tasks (camera group), the second group practiced performing a simulation-based cholecystectomy (procedure group), and the third group received no training (control group). Participants were surgical novices without prior laparoscopic experience. The primary outcome was assessment of camera navigation skills during a laparoscopic cholecystectomy. The secondary outcome was technical skills after training, using a previously developed model for testing camera navigational skills. The exploratory outcome measured participants' motivation toward the task as an operating assistant.
  
  
  
  Thirty-six participants were randomized. No significant difference was found in the primary outcome between the three groups (p = 0.279). The secondary outcome showed no significant difference between the interventions groups, total time 167 s (95% CI, 118-217) and 194 s (95% CI, 152-236) for the camera group and the procedure group, respectively (p = 0.369). Both interventions groups were significantly faster than the control group, 307 s (95% CI, 202-412), p = 0.018 and p = 0.045, respectively. On the exploratory outcome, the control group for two dimensions, interest/enjoyment (p = 0.030) and perceived choice (p = 0.033), had a higher score.
  
  
  
  Simulation-based training improves the technical skills required for camera navigation, regardless of practicing camera navigation or the procedure itself. Transfer to the clinical setting could, however, not be demonstrated. The control group demonstrated higher interest/enjoyment and perceived choice than the camera group.
authors: Department of Obstetrics and Gynecology, The Juliane Marie Centre for Children, Women and Reproduction, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark. cecnilsson@gmail.com.
authors: Cecilia
authors: 0000-0001-6877-502X
authors: C
authors: Nilsson
authors: Department of Obstetrics and Gynecology, The Juliane Marie Centre for Children, Women and Reproduction, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark.
authors: Jette Led
authors: JL
authors: Sorensen
authors: Copenhagen Academy for Medical Education and Simulation, Copenhagen, Denmark.
authors: Lars
authors: L
authors: Konge
authors: Department of Surgery, Hvidovre Hospital, Copenhagen, Denmark.
authors: Mikkel
authors: M
authors: Westen
authors: Department of Surgery, Hvidovre Hospital, Copenhagen, Denmark.
authors: Morten
authors: M
authors: Stadeager
authors: Department of Obstetrics and Gynecology, The Juliane Marie Centre for Children, Women and Reproduction, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark.
authors: Bent
authors: B
authors: Ottesen
authors: Department of Obstetrics and Gynecology, The Juliane Marie Centre for Children, Women and Reproduction, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen, Denmark.
authors: Flemming
authors: F
authors: Bjerrum
mesh_terms: D000328:Adult; D017081:Cholecystectomy, Laparoscopic / Q000193:education*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000193:education*; D000066908:Simulation Training; D013337:Students, Medical; D000076142:Virtual Reality; D055815:Young Adult
keywords: Camera navigation; Laparoscopic surgery; Motivation; Simulator; Surgical education; Virtual reality