Background:
Compare the development of skills in intracorporeal laparoscopic suturing of novice and expert attendants to 21 hour hands-on courses in digestive surgery

Material and Methods:
38 attendants were classified according their laparoscopic experience. GroupI = 18 novices(N) with no previous experience (basic course). GroupII = 20 expert surgeons (E)(advanced course). On the first day’s hands-on session, surgeons completed a simple intracorporeal suture on simulator. This task was repeated during the last day in porcine model. Total completion time and performance errors were registered and both measures were taken before (i) and after (f) the course.

Result:
GroupI significantly reduced suture completion time on the last day of the course (Ni 5.03±1.47 minutes vs. Nf 2.81±1.19 minutes, p<0.001). Similarly, GroupII significantly improved suturing times (Ei 3.87±1.53 minutesvs.Ef 2.21±0.86 minutes, p<0.05). Also GroupII completed the task significantly faster on the first day than GroupI (Ni 5.03±1.47 minutesvs.Ei 3.87±1.53 minutes, p=0.001), differences that were no longer found at the end of the training activity (Nf 2.81±1.19 minutesvs.Ef 2.21±0.86 minutes). Performance errors was significantly reduced for GroupI (Ni=44.4%vs.Nf=22.2%, p<0.05), and for Group II, without statistical differences (Ei=15%vs.Ef=5%).

Conclusion?
both novice and expert surgeons improved their dexterity in intracorporeal suturing after completing a regulated course on laparoscopic general surgery. At the end of the course, novice surgeons are almost as fast as experts, although maintaining significant manoeuvre quality differences.