Effectiveness of Thai-German Multidisciplinary Endoscopic Training (TG-MET) simulator for laparoscopic training

Objectives: To evaluate effectiveness of Thai-German Multidisciplinary Endoscopic Training (TG-MET) protocol and identify the appropriate practice time and factors affecting the training protocol. Materials and Methods: A total of 29 obstetrics and gynecology residents who had no laparoscopic surgery experience were enrolled in a 2-week training program. During the training, participants did the 15 minute-test, including moving beans, cutting the paper into star shape, and simple suturing. Evaluation was done at 5 and 10 hours of training by video recording the tests and interpreted by Global Operative Assessment of Laparoscopic Skills (GOALS) score by two experienced laparoscopists. Scores were compared between tests at the beginning, 5 and 10 hours of training. Various characteristics were compared between those who passed and did not pass the tests. Results: Mean GOALS scores increased significantly at 5 and 10 hours of training (12.3 vs. 18 vs. 19.3, p < 0.001). All domains including depth perception, bimanual dexterity, efficiency, tissue handling, and autonomy were significantly improved at 5 hours (p < 0.05). However, only depth perception, bimanual dexterity and efficiency were significantly improved at 10 hours. Participants who can play musical instrument had significantly higher rate of passing the tests at 5 hours of training (50% vs 9.1% p = 0.044). No associated factors related to passing the exam at 10 hours. Conclusion: Training with TG-MET protocol can significantly improve laparoscopic skills at 5 hours significantly and tend to reach the plateau at 10 hours. However, the tasks such as depth perception, bimanual dexterity and efficiency still improved at 10 hours.