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Eur J Pediatr Surg 2016; 26(05): 436-442
DOI: 10.1055/s-0035-1564712
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Training Significantly Improves Fetoscopy Performance: A Pilot Randomized Controlled Trial

Authors

  • Stefan Mietzsch

    1   Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

  • Johannes Boettcher

    1   Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
    2   Institute of Psychology, University Kiel, Kiel, Germany

  • Sisi Yang

    3   Hamburg University of Technology, Hamburg, Germany

  • Pierre Chantereau

    3   Hamburg University of Technology, Hamburg, Germany

  • Philip Romero

    4   Department of Surgery, Section of Pediatric Surgery, University Hospital Heidelberg, Heidelberg, Germany

  • Robert Bergholz

    1   Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

  • Konrad Reinshagen

    1   Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

  • Michael Boettcher

    1   Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Weitere Informationen

Publikationsverlauf

19. Mai 2015

23. August 2015

Publikationsdatum:
07. Oktober 2015 (online)

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Abstract

Background Implementation of complex fetoscopic procedures that included intracorporeal suturing has been limited due to technical difficulties that might be surmounted with adequate training. Evaluating the impact of laparoscopic or fetoscopic training on fetoscopic performance was the aim of this study.

Methods To evaluate fetoscopic performance after either laparoscopic or fetoscopic training, subjects were asked to perform four surgeon's square knots fetoscopically prior and post 2 hours of hands-on training. All subjects were medical students and novice in laparoscopic and fetoscopic interventions. Total time, knot stability (evaluated via tensiometer), suture accuracy, knot quality, and fetoscopic performance were assessed.

Results Forty-six subjects were included in the study; after simple randomization, 24 were trained fetoscopically and 22 laparoscopically. Both groups had comparable baseline characteristics and improved after training significantly regarding all aspects assessed in this study. Subjects who trained fetoscopically were superior in terms of suturing and knot-tying performance.

Conclusion Training significantly improves fetoscopic performance and may indeed be the keystone for future complex fetoscopic interventions. It seems advisable to train rather fetoscopically than laparoscopically resulting in higher suture and knot-tying quality.

Keywords

laparoscopy - fetoscopy - training

Contributors' Statement

Stefan Mietzsch: Mr Mietzsch acquired data, acted as course instructor, and approved the final manuscript as submitted.


Johannes Boettcher: Mr Boettcher acquired data, conceptualized the questionnaire, validated statistics, and approved the final manuscript as submitted.


Sissi Yang: Ms Yang performed tensile strength measurement and approved the final manuscript as submitted.


Pierre Chantereau: Mr Chantereau performed tensile strength measurement and approved the final manuscript as submitted.


Philip Romero: Dr Romero conceptualized and designed the study, and approved the final manuscript as submitted.


Robert Bergholz: Dr Bergholz conceptualized and designed the study, and approved the final manuscript as submitted.


Konrad Reinshagen: Prof Dr Reinshagen conceptualized and designed the study, and approved the final manuscript as submitted.


Michael Boettcher: Dr Boettcher conceptualized and designed the study, acquired data, acted as course instructor, performed statistics, drafted the initial manuscript, and approved the final manuscript as submitted.


All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.