LAP Mentor’s comprehensive content and unprecedented simulation capabilities enable the GSL SMART Lab to be one of a kind in India for laparoscopic training
Founded in 2012 by Dr.Bhaskara Rao Ganni, GSL SMART Lab is a “collective effort of the GSL College of Medicine, the GSL College of Nursing and Health Science, serving as an incorporated center point of training healthcare professionals with a definitive goal of enhancing quality and safety of care.”

THE CHALLENGE
As clinical medicine is becoming focused more on patient safety and the quality of care, medical simulation has been proposed as a means to bridge the educational gap between the classroom and the clinical environment.

Dr. Sandeep Ganni, the director of the GSL SMART Lab (Simulated Modules for Advanced Research and Training Laboratory) in India and a research fellow at Catharina Hospital in the Netherlands, envisioned a “world class surgical and medical training center where physicians and healthcare professionals could learn skills through simulation training and aimed at remodeling the approach toward patient safety and healthcare in India.” He was looking for different simulators for different specialties to provide both basic and advanced simulation training.

When looking for a simulator for laparoscopic surgery, Dr. Ganni was interested in a new age high fidelity simulator that could provide basic surgical and suturing skills training for international accreditation as well as specific hands-on training in complex laparoscopic procedures for practicing physicians in India. Equally important was a means of measuring the acquirement of those skills before the trainee actually performed those procedures in the OR.

THE SOLUTION
The GSL SMART Lab purchased 3D Systems’ LAP Mentor simulator for hands-on practice of basic skills and surgical procedures. A 6-month course using the LAP Mentor was designed to provide surgical and suturing skills to acquire LSS certification. The course is available for surgical residents from GSL College of Medicine as well as surgical residents in medical colleges throughout India. In addition, 8-10 month courses are offered with a specific training curriculum for advanced laparascopic surgical procedures.  Trainees practice procedures, crisis management and team work by simulation. This simulation-based training is one of a kind in India.

According to Dr. Ganni, the benefits and advantages of the LAP Mentor for their laparascopic simulation program are:

Realistic Training – The simulator has excellent haptic feedback so that you can really feel the resistance of the tissues as you manipulate them. In addition, the simulation itself is very realistic; the anatomy and tissues behave like in real-life when dissected, manipulated and sutured. The whole interaction between the surgical instruments and the anatomical environment is very similar to the actual procedure.

Skill Sets and Procedural Modules – The wide variety of modules, tasks and cases provide both basic and advanced simulation training for beginning students as well as practicing physicians. This allows for designing a wide variety of simulation training courses at the GSL SMART Lab.

LSS Certification – LSS (Laparoscopic Surgical Skills) is an initiative by the European Association for Endoscopic Surgery (EAES) to provide a standard to (re)credential surgeons to perform laparoscopic surgery effectively and safely. GSL SMART Lab has collaboration with LSS, the Netherlands, the Indian Association of Gastro Endoscopy Surgeons and the Indian National Board of Examinations to train physicians for short and diploma courses in simulation training.

The LAP Mentor offers a specific LSS course which prepares the trainee for the LSS examination and subsequent accreditation. It is an important tool for learning and practicing the surgical skills and procedures needed to successfully receive the LSS Certification of Accreditation as well as the actual simulator for conducting the LSS examination.

Guided Procedures and Free-Hand Training – Dr. Ganni said:  “Another thing that I liked is the procedures are divided into step-by-step tasks which help the trainees remember the whole surgical procedure.” They can understand the steps and be able to make the transition from the beginning of the procedure cleanly to the end of the procedure. Once the trainees feel comfortable with the Guidance part of the simulation, they can go a step further with the free-hand procedure with no guidance prompting. This has huge implications for trainees who are learning the operation and then performing them in the OR. They will be able to apply that in a very efficient way in the OR.

Measuring Performance – We can set benchmarks (proficiency levels) for certain metrics and expect the trainees to get to these levels in order to proceed to the next step in the operation before going to the actual operating room. We use our debriefing room to review with them their errors and discuss how to improve themselves.

Service – The service provided by 3D Systems is outstanding and an important factor to making sure that the SMART Lab functions efficiently.

THE OUTCOME
“We are doing a lot of evaluation programs in India because it allows us to evaluate students who are undergoing simulation programs and those who don’t have the training in a skills lab. We have received a wide range of positive studies that show that students perform significantly better in the OR when they participated in the laparascopic surgical skills lab program. Students who have had training on the LAP Mentor were 70% more proficient than the control group who had no simulation training. They had 70% less complications and errors, were more confident and proficient so that the surgeons did not need to take over during the operation.”1 The LAP Mentor plays a very crucial part in this successful training of surgical residents here in India.

1  Ganni S, Goossens RHM and Jakimowicz JJ, Validating training and assessment in Minimal Access Surgery (MAS) in India – Preliminary results, presented at WCES, Shanghai in 2016.