Structured Basic Laparoscopic Surgical Skill Using A Low Cost Simulation Box For Medical Students In A Lower-resource Setting.

Structured Basic Laparoscopic Surgical Skill Using A Low Cost Simulation Box For Medical Students In A Lower-resource Setting.

Sulav Katuwal , Ashmita Khatri, Prarthana Subedi, Mahmoud Loubani, Bishow Karki
Chitwan Medical College, Chitwan, Nepal; KIST Medical College, Kathmandu, Nepal; National Academy of Sciences, Kathmandu, Nepal; Hull university teaching hospitals, NHS Trust, Hull, United Kingdom

Introduction: Laparoscopic surgery requires mastery of depth perception, hand-eye coordination, and bimanual dexterity. However, there is limited simulation-based training in LMICs primarily for the medical students. To address this gap, we developed and utilized a low-cost laparoscopic simulation box to deliver structured skill training.

Aim: To enhance basic surgical skills through structured tasks performed on a low cost laparoscopic simulator and skill exercises tailored for medical students.

Methods and Methodology: A total of 7 participants attended the training and completed 3 exercises.

Sugarcube staking: To improve depth perception
Two-Handed POLO: Transfer Across Soap-Based Toothpick Pillars
Polos on a string: Bimanual coordinated task

Each exercise was performed under supervision of the Lap Trainers.

Result: Seven medical students participated. Confidence in holding laparoscopic instruments improved from 1.14 ± 0.38 to 2.86 ± 0.64; bimanual tasks improved from 1.14 ± 0.38 to 2.86 ± 0.64, and basic tasks (grasp, transfer, cut) improved from 1.0 ± 0.0 to 3.0 ± 0.82. Knowledge of the fulcrum effect and depth perception increased from 14.3% ± 12.9 to 100% ± 0. All participants (100%) agreed that there is a need for basic laparoscopic training in the early undergraduate curriculum in LMICs.

Conclusion: Although all present delegates were medical students but in order to support the development of laparoscopic surgery, there is a need to introduce these skill sets early in their careers. Significant confidence gains demonstrate the effectiveness of this low-cost simulation course, underscoring the need for its integration into early undergraduate curriculum in lower-middle-income countries to strengthen foundational laparoscopic skills.

Keywords: fulcrum effect , depth perception