RF 8 - EVALUATING SURGICAL RESIDENTS' ATTITUDE TOWARD LAPAROSCOPIC COLORECTAL SIMULATION: A PORCINE MODEL

Objectives: Minimally invasive surgical techniques have replaced open approaches in many of the most commonly performed surgical procedures. Several factors pose challenges in mastering laparoscopic techniques during resident surgical training, such as: 80 hour work week restrictions, decreased autonomy, case competition with fellows, and the steep learning curve associated with laparoscopic techniques. Therefore, with our study, we aimed to determine the effectiveness of utilizing porcine models to improve surgical resident comfort with standard hemostatic and laparoscopic colorectal techniques.

Methods: Nine surgical residents between PGY2 and 5 completed a course focused on colorectal laparoscopic technique and the proper use of hemostatic agents. The course was designed by colorectal faculty with input from industry sponsors who also assisted with funding and supplementation of laparoscopic instruments and hemostatic agents. The course started with a pretest evaluation, followed by a didactic lecture, and a skills session using a porcine model to practice laparoscopic hemostatic and colorectal techniques. Participants performed laparoscopic procedures such as a right hemicolectomy and sigmoidectomy with a variety of laparoscopic staplers and energy devices. Then, residents attempted hemostatic techniques utilizing hemostatic agents after a structured series of bleeding injuries occurred. The lab concluded with the completion of a post-test survey focusing on competency and confidence surrounding laparoscopic colorectal techniques and hemostasis adjuncts.

Results: Nine residents completed training using the porcine model. There was a 100% pretest and 100% posttest evaluation completion. Pretest surveys demonstrated that 8/9 residents had an intermediate level of confidence in using hemostatic adjuncts in laparoscopic surgery, while 1/9 had a beginner level. Regarding laparoscopic bowel resection and anastomosis, 6/9 residents had a beginner level of experience with the remaining 2/9 reporting an intermediate level. Post-test surveys showed that 8/9 residents strongly agreed that porcine models were useful for resident training in laparoscopic colorectal and hemostatic techniques. All residents (9/9) felt the lab provided valuable improvements to their surgical abilities and would recommend the lab to their peers.

Conclusion: Our study shows that surgical residents' level of comfort with laparoscopic and hemostatic technique is often suboptimal regardless of the post graduate year of the resident. A paired didactic and porcine lab model for laparoscopic colorectal and hemostatic techniques is a valuable method for improving resident knowledge and skills in a low-stakes environment.

Funding: This work was supported by Ethicon US, LLC, Cincinnati, OH