BACKGROUND

Simulated video training has emerged as an effective method to enhance the surgical skills. However, in the local context, there is an absence of data contrasting the outcomes of unsupervised video training with the conventional supervised approach in surgical skill development.

OBJECTIVE

The objective of this study was to evaluate and contrast the performance score and total operating time between unsupervised video training simulations and supervised video training simulations, specifically in the domain of 30° hysteroscopic camera navigation.

MATERIALS AND METHODS

A single-blinded randomized controlled trial involved 24 obstetrics and gynecology residents in a tertiary government institution. Participants were randomized into Group A (unsupervised video training) and Group B (proctor-supervised simulation training). Utilizing a uterine model, both groups undertook nine designated tasks. The training process included a pretest simulation, 5 training repetitions, and a concluding posttest simulation. The principal investigator documented operating times and hand movements posteach session. Subsequently, a blinded Philippine Society for Gynecologic Endoscopy board-certified gynecologic endoscopist assessed these videos, using the Global Hysteroscopy Rating Scale for scoring.

RESULTS

The total operating time and performance score during posttest among Group A and Group B showed no significant difference (Group A 0.77 ± 0.19 min Group B 0.71 ± 0.15 min) (P = 0.377) (Group A 13.50 ± 1.73 Group B 13.83 ± 1.53) (P = 0.622) which suggest that participants performed comparably regardless of instructional method. On the Global Rating Scale (GRS) score, higher percentage of participants from Group B showed improved performance on respect for tissue, time and motion, and handling of hysteroscope as compared to Group A.

CONCLUSION

The video-based training simulation is effective as expert proctoring in hysteroscopic camera navigation. However, there was slightly greater improvement in the GRS scores in the proctor supervised group which suggest that feedback from proctors has a positive impact on the performance.

Human ; Hysteroscopy

Objective: This study aims to establish baseline information on the practice of minimally invasive gynecologic surgery (MIGS) among Filipino gynecologic endoscopists amid the COVID-19 pandemic. Materials and Methods: MATERIALS AND METHODS: An online survey was conducted among Fellows of the Philippine Society for Gynecologic Endoscopy (PSGE) practicing in private and government hospitals in the Philippines after informed consent. The survey had five subsections: (1) demographic data, (2) impact of COVID-19 pandemic on MIGS practice, (3) changes of practice during the COVID-19 pandemic, and (4) changes in the conduct of surgery and postoperative care. Results: A total of 119 out of 144 PSGE Fellows based in the Philippines participated in the survey, 83% were Fellows in both laparoscopy and hysteroscopy. The majority had more than 15 years of practice and were practicing in the National Capital Region. Surgeries were canceled initially but have since resumed. The majority were hysteroscopy cases, the most common being polypectomy. Majority of the respondents reduced their clinic hours and appointments. Most have used telemedicine for consultations. Use of face masks, face shields, and personal protective equipment (PPE) were the top precautions taken in the clinics. Screening and precautions per guidelines inside the operating room setting were observed. Modifications during surgery include the use of smoke evacuators, minimizing energy device use, and wearing enhanced PPE. Conclusion The volume of laparoscopy and hysteroscopy cases was greatly reduced during the pandemic. The pandemic has disrupted the practice of MIGS both in the outpatient clinics and the operating rooms. Most of the changes made are congruent to local and international automotive task force guidelines. Precautionary measures and screening procedures must remain in place to reduce the risk of severe acute respiratory syndrome coronavirus 2 transmission to patients and health-care workers.
COVID-19 ; Personal Protective Equipment ; Telemedicine