There has long been an urgent need for an universally recognized practical training programme in laparoscopic surgery with different levels of difficulties and validated tests. That is why +he Academy has recently developed a trainer box called “The Laparoscopic Skills Testing and Training model” (LASTT) aimed to train and measure three specific LPS: laparoscopic camera navigation, hand eye coordination and bimanual coordination. This model proved to be feasible as its face validity (the realism of the model) and construct validity (the capacity of the model to differentiate between surgeons with different levels of experience) could be proven (Molinas et al., 2008; Campo etal., 2010).
The LAST+T method uses a model to measure three practical laparoscopic psychomotor skills. The individual scores are reported on the online Academy Scoring Platform by the mentors. Reports are generated on location.
Exercises are done in pair and participants have to change position after every run. Exercise 1 takes 2 minutes and exercise 3 is limited to 3 minutes.
EXERCISE 1: camera navigation
- Objective is to visualize the reach of all important area’s of the pelvis
- Camera handling with a 30° optic and introduce it in the central middle port
- Camera head in non-dominant hand
- Rotate with your DH for correct view
- Screen is equipped with a transparent with circle in the middle
- Now watch the exercise
EXERCISE 2: Hand-eye coordination
- Change model set-up: introduce the colour inserts
- Position from the 6 coloured objects (rings) 2 each in a circle around the Academy logo
- Mount the 0° optic and introduce it in the central middle port
- Use the Kelly Forceps, in the middle lateral port, with your dominant hand
- Position ONE colour ring on each corresponding nail
- If you drop an object, you have a second ring, or you may re-grasp, as far as you can find the object within the endoscopic boundaries
EXERCISE 3: Bi-manual coordination
- Position 6 coloured pins around the logo 2 times each
- Camera handeling with a 0° optic in the central middle port, Kelly Forceps in dominant hand. Mathokwitz Forceps in non-dominant hand, introduced in the middle lateral ports.
- Grasp the head (plastic) with the Matkowitz Forceps and re-graso the tail (steel) with the Kelly Forceps; position one colour pin on each corresponding circle
- If you drop an object, you have a second pin, or you may re-grasp, as long as you can find the object with your endoscopic boundaries.