Residency Training in General Surgery

Using Surgical Simulation of Laparoscopic Colorectal Surgery

The operating room is not the best classroom for developing some of the new surgical skills that surgeons must now have. With the new mandate from the American College of Surgeons on the fundamentals of laparoscopic skills, there has been more emphasis than ever on surgical simulation. Dr. Roberto Bergamaschi, chief of colon and rectal surgery, works closely with our residents on surgical simulation using the hybrid colorectal surgery simulator called ProMIS LC.

Third- and fourth-year surgical residents are trained and tested on the laparoscopic skills required for sigmoid resection for cancer. Stony Brook's state-of-the-art Surgical Skills Center, which houses an operating room with availability of external cameras and microphones, is the ideal classroom for this laparoscopic training.

Dr. Roberto Bergamaschi (center) demonstrating laparoscopic technique with the colorectal surgery simulator in our Surgical Skills Center.

The hybrid simulation model we use for training residents is well designed for the purpose of laparoscopic simulation, because it offers tactile feedback on a physical colorectal model with the same instruments used in the actual operating room, and because its objective evaluation cameras track the instruments in 3D space.

All residents undergo a number of educational interventions, which include the viewing of a video of the standardized procedural skills for laparoscopic sigmoid resection performed by an expert. The residents also are familiarized with the ergonomic position of the hybrid colorectal surgery simulator by observing and viewing a video of a laparoscopic sigmoid resection performed by an expert using the ProMIS surgical simulator.

Before the training begins, the participants perform a baseline laparoscopic sigmoid resection according to the same standardized procedural steps using a disposable physical model in the hybrid colorectal surgery simulator.

The residents then proceed to training following the same procedural steps on the same simulator until established proficiency levels are achieved. In this way, the residents eventually perform a final laparoscopic sigmoid resection in accord with the same procedural steps using the same physical model in the same simulator.

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