Evaluation of the Educational Impact of a Laparoscopic Bowel Anastomosis Simulator.

Abstract

Background and objectives: The bowel anastomosis training simulator (BATS) was developed to provide realistic training in hand-sewn bowel anastomosis, previously validated for open techniques. As minimally invasive surgery (MIS) advances, effective laparoscopic training is increasingly essential. This pilot prospective cohort study aimed to evaluate the laparoscopic educational impact and validity of BATS, incorporating a structured pretask video review.

Methods: We conducted a prospective cohort study of involving 34 surgical fellows participating in a national surgical education course. All participants completed a structured laparoscopic suturing curriculum that included a pretask instructional video, a 30-minute hands-on session using the BATS simulator, two and a half hours of suturing practice on porcine models, one hour for porcine laparoscopic cholecystectomies, and one hour for 3 additional side stations. Pre and postcourse surveys assessed simulator realism, simulator educational value, as well as self-reported confidence in laparoscopic hand-sewn bowel anastomosis using a 5-point Likert scale.

Results: Survey responses demonstrated high ratings for simulator realism and educational value. Baseline confidence in laparoscopic anastomosis was low (mean 2.67). Post-training, confidence significantly improved following BATS simulation (mean 4.00, P ≤ .01) and porcine model training (mean 3.95, P = .01).

Conclusions: In this pilot study, BATS realism and educational value were confirmed. The simulator's standardized design and reproducibility make it a valuable addition to MIS training programs. Structured training with the BATS simulator significantly improved fellow confidence in laparoscopic hand-sewn anastomosis. Further studies should assess objective performance outcomes and long-term skill retention.