RCT Comparing Home vs Hospital Training Using Portable Laparoscopic Endo-Trainer
Overview
This randomized controlled trial evaluated laparoscopic skill acquisition using the portable laparoscopic endo-trainer (PLET) at home versus hospital settings among surgical residents. Results demonstrated comparable improvements in surgical skills measured by OSATS scores over 12 weeks in both groups, supporting home-based training as an effective alternative to hospital-based practice.
Background
Laparoscopic procedures are the gold standard for most abdominal surgeries, necessitating proficient laparoscopic skills among surgical residents. Traditional training methods are challenged by limited OR opportunities, working hour restrictions, and increased administrative duties. The COVID-19 pandemic further reduced elective surgeries and training chances, emphasizing the need for flexible training solutions. Portable trainers like the PLET offer a potential means to facilitate skill acquisition outside the hospital environment.
Data Highlights
Parameter
Home-Based Group
Hospital-Based Group
Participants (n)
12
12
Training Duration
12 weeks
12 weeks
Primary Outcome
OSATS score improvement
OSATS score improvement
Statistical Power
74% with 24 participants
Key Findings
Both home- and hospital-based training groups showed significant improvement in laparoscopic skills over 12 weeks as measured by OSATS.
No significant difference was found between the two groups in skill acquisition, indicating home training is as effective as hospital training.
The PLET device is portable, easy to assemble, and includes five different laparoscopic exercises with instructional videos accessible anytime.
Participants had access to senior surgeon support via phone, email, or in person, ensuring guidance regardless of training location.
Qualitative feedback highlighted motivation challenges and the impact of COVID-19 on training opportunities, with home training offering flexibility during pandemic restrictions.
Clinical Implications
Home-based laparoscopic training using portable devices like the PLET can effectively supplement hospital-based education, especially when OR access is limited. This approach allows surgical residents to maintain and improve skills flexibly, which is particularly valuable during pandemics or periods of restricted clinical exposure. Incorporating portable trainers into residency curricula may enhance skill acquisition without increasing resource demands in hospital settings.
Conclusion
The study supports the use of portable laparoscopic trainers for home-based skill development, demonstrating comparable effectiveness to traditional hospital-based training. This modality offers a practical solution to overcome training limitations imposed by workload, scheduling, and external factors such as the COVID-19 pandemic.
References
Linke et al. 2024 -- A Randomized Controlled Trial Comparing Home and Hospital-Based Training Using the Portable Laparoscopic Endo-Trainer (PLET)
