Comparing Proficiency of Laparoscopic Vaginal Cuff Suturing After Training with Two Simulators

Objective: To evaluate whether a gynecology-specific laparoscopic trainer better prepares premedical and medical students to perform a laparoscopic vaginal cuff surgical task than the current standard laparoscopic trainer. Methods: In a masked, block-randomized controlled trial, 49 premedical and preclinical medical students were recruited, then randomized to a laparoscopic simulator: Essentials in Minimally Invasive Gynecologic Surgery (EMIGS) or Fundamentals of Laparoscopic Surgery (FLS). A total of 26 participants were initially randomized to EMIGS and 23 participants to FLS. They trained for 2.5 hours on their assigned simulator. Video recordings of participants performing a laparoscopic vaginal cuff suturing task were collected before and after simulator training. Videos were masked and reviewed by expert minimally invasive gynecologic surgery (MIGS) surgeons and graded using a modified Global Operative Assessment of Laparoscopic Skills (GOALS) rubric. The pretraining and post-training GOALS scores were then compared between simulator groups. Results: Most demographic characteristics were similar across both groups. Ultimately, 24 participants from the EMIGS group and 21 participants from the FLS group were included in the final analysis. The mean difference between post and pre-composite GOALS scores was 6.50 for EMIGS and 4.07 for FLS, P 5 .34. The mean EMIGS post-pre difference was greater for six of the eight individual GOALS domains, although all P-values > .05. Conclusions: Neither EMIGS nor FLS was associated with better performance on the vaginal cuff suturing task after a single 2.5-hour training session.