Practicing urologist learning laparoscopy: No short cut to short cuts

To emphasize the importance of regular exercising in dry lab in initial phase of learning of laparoscopic surgery by a practicing urologist. The study was performed at Dry Lab -Jayaramdas Patel Academic Centre (JPAC) attached to Muljibhai Patel Urological Hospital, Nadiad, India. The study is based on 30 sets of exercises of four standard tasks utilized to learn Hand-Eye coordination for Laparoscopic Surgery. All sets were performed by a single participant over a period of 19 days and the exercise record was retrospectively analyzed. The participant had limited exposure of one year in a low volume laparoscopy center. Correlation between Exercise number and Task Completion Time (TCT) was calculated by Pearson's Correlation Coefficient and its significance is assessed by Student paired t test. The current study describes 30 exercises of 4 standard tasks for hand-eye-coordination. Although the study was completed in 19 days but there were two intervals which point to the objective of this study. First interval was of 3 days and it occurred after 4th exercise. At 5th exercise the Task Completion Time started rising more than the 2nd exercise. This regression further worsened on 6th exercise which had an interval of 2 days. Here the (TCT) went up almost equal to 1st exercise (1050 vs 1054 seconds). Mean time for IT1, IT2, IT3, IT4 and TCT of over all exercises were calculated as 24.2 +/- 3.7, 121.9 +/- 54.9, 233 +/- 73.5, 199 +/- 55.1 and 582.5 +/- 174.8 seconds respectively. Significant correlation was noticed between number of exercises performed and improvement in time taken for individual tasks (IT 2 to IT4) and TCT. However there was no significant impact on Task 1. Regular Dry Lab exercises improves hand eye coordination and psychomotor skill dedicated continuous exercising has significant impact in reducing TCT.