Improving operative performance using a laparoscopic hernia simulator

Elizabeth Costa Hamilton, Daniel J Scott, Ajay Kapoor, Ohwofiemu E Nwariaku, Patricia C Bergen, Robert V Rege, Seifu T. Tesfay, Daniel B. Jones

Research output: Contribution to journalArticlepeer-review

106 Scopus citations


Background: Traditionally, the acquisition of surgical skill has occurred entirely in the operating room. To meet the expanding challenges of cost containment and patient safety, novel methods of surgical training utilizing ex-vivo workstations are being developed. The purpose of our study was to evaluate the impact of a laparoscopic training curriculum on surgical residents' operative performance. Methods: Twenty-one surgery residents completed baseline laparoscopic total extraperitoneal (TEP) hernia repairs. Operative performance was evaluated using a validated global assessment tool. Each resident was then randomized to a control group or a trained group. A CD ROM, video, and simulator were used for training. At the end of the study, each resident's operative performance was again evaluated. Results: Improvement was significantly greater in the trained group in five of the eight individual global assessment areas as well as the composite score (P <0.05). Questionnaire data suggested that training resulted in improved understanding of the TEP hernia repair (P = 0.01) and an increased willingness to offer the operation to patients with nonrecurrent unilateral hernias (P = 0.02). Conclusions: A multimodality laparoscopic TEP hernia curriculum improves residents' knowledge of the TEP hernia repair and comfort in performing the procedure, and may also improve actual operative performance.

Original languageEnglish (US)
Pages (from-to)725-728
Number of pages4
JournalAmerican journal of surgery
Issue number6
StatePublished - 2001


  • Global assessment
  • Laparoscopic total extraperitoneal hernia repair
  • Simulation
  • Skills training
  • Surgical education

ASJC Scopus subject areas

  • Surgery


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