IMPERIAL COLLEGE LAPAROSCOPIC CHOLECYSTECTOMY TRAINING CURRICULUM
Training within a proficiency-based virtual reality curriculum may reduce errors during real surgical procedures. The following curriculum is based on Development of a Virtual Reality Training Curriculum for Laparoscopic Cholecystectomy (Darzi et al. British Journal of Surgery 2009; 96: 1086–1093).
The study, by the Department of Biosurgery and Surgical Technology at St. Mary’s Campus at Imperial College of London, defined, tested and validated a whole-procedure virtual reality training curriculum for laparoscopic cholecystectomy on the Simbionix LAP Mentor™ using structured scientific methodology. The curriculum clearly defines a predetermined level of proficiency as well as defining the mode of training on the simulator.
The aim of the training curriculum is for an individual to acquire skills and reach a predetermined level of proficiency before progressing to more challenging cases.
- To practice and acquire competence in basic laparoscopic skills: Camera manipulation 0°; Camera Manipulation 30°; Eye-hand coordination; Clip application; Clipping and grasping; Two-handed maneuvers; Cutting; Electrocautery; Translocation of objects.
- To demonstrate proficiency in basic laparoscopic skills by achieving the validated level of skill required in clipping and grasping, and two-handed maneuvers tasks.
- To practice procedural laparoscopic cholecystectomy tasks: Clipping and cutting a retracted gallbladder; Clipping and cutting using two hands; Calot’s triangle dissection; Gallbladder separation.
- To demonstrate proficiency in procedural tasks of laparoscopic cholecystectomy by achieving the validated level of skill required in the Calot’s triangle dissection and Gallbladder separation tasks.
- To master and reach confidence in a complete cholecystectomy procedure by hands-on practice of a virtual patient case.
- To demonstrate the validated level of skill required for the full cholecystectomy procedure while performing a simulated case.
Individuals interested in following a structured curriculum to acquire skills to reach a predetermined level of proficiency, before progressing to more challenging cases enabling the trainee to transfer these skills to the real OR environment.
It is recommended to include a cognitive skills module at the front end of the training program. No previous procedural or technical knowledge is required.
Suggested Time Length
Distributed training schedules, with a maximum of two sessions performed per day, each at least one hour apart, until demonstrating the required level of skill by achieving all benchmark levels in two consecutive sessions.
This curriculum is based on Development of a virtual reality training curriculum for laparoscopic cholecystectomy (Darzi et al. British Journal of Surgery 2009; 96: 1086–1093).