Effect of Short- Versus Long-Term Video Game Playing on Basic Laparoscopic Skills Acquisition of Veterinary Medicine Students

The objective of this study was to investigate the effect of playing video games on the performance of basic laparoscopic skills. The study was an experimental pre-test-post-test comparison group design. Fifty-two students (31 from the Western University of Health Sciences College of Veterinary Medicine and 21 from the Colorado State University College of Veterinary Medicine) completing their first or second year of the veterinary curriculum were randomized into two intervention groups. The intervention consisted of playing the video game Marble Mania on a Nintendo Wii. group L (long) played 18 hours over 6 weeks and group S (short) played 3 hours during the last week of the 6-week intervention period. Before and after the intervention, basic laparoscopic skills for both groups were assessed using a modified McGill Inanimate System for Training and Evaluation of Laparoscopic Skills (MISTELS) instrument. Participants performed two laparoscopic tasks. Results showed that the performance of students improved in both group S and L (p < .05) on both laparoscopic tasks. Both groups showed statistically significant improvement in their post-intervention scores (group L, N = 25, z = -3.711, p < .001, r = 0.742; group S, N = 27, z = -3.016, p < .003, r = 0.580). There was no significant difference in the degree of improvement between group S and group L. The results suggest that playing Marble Mania on a Wii for any time duration could be an effective method for veterinary medicine students to improve basic laparoscopic skills, and indicate the needs for additional studies.

A Comparison of Knot Security of Commonly Used Hand-Tied Laparoscopic Slipknots

OBJECTIVE

To compare the peak force required for failure of hand-tied laparoscopic slipknot ligatures.

STUDY DESIGN

In vitro mechanical evaluation of suture material/knot combinations.

SAMPLE POPULATION

Four hand-tied laparoscopic slipknots were studied. Three suture materials and 2 suture sizes were evaluated. Twenty samples of each group were tested, for a total of 400 samples.

METHODS

The 4S modified Roeder, modified Roeder, and Weston and Brooks laparoscopic slipknots using 0 polyglyconate, 0 polyglycolic acid, 1 polyglyconate, and 1 polydioxanone (PDS) were tested. A vertical distracting force (5 mm/s) was applied until failure. Mean peak force to failure was obtained for each suture material, size, and knot combination.

RESULTS

Mean (+/-SEM) peak force to failure of hand-tied ligatures ranged from 156.8+/-9.1 N to 4.8+/-.4 N. The 4S-modified Roeder had the highest mean peak force to failure. Ligatures tied with polyglyconate and size 1 suture had the highest mean peak force to failure.

CONCLUSIONS

The 4S-modified Roeder was significantly and consistently stronger than the other slipknots. Polyglyconate was superior to other suture materials. The 1 polyglyconate had the highest mean peak force to failure followed by 0 polyglyconate that exceeded the 1PDS.

CLINICAL RELEVANCE

The 4S-modified Roeder slipknot using 1 polyglyconate has the greatest breaking strength of sutures tested and should be considered when performing laparoscopic ligatures.

Complications in laparoscopic surgery

As laparoscopic surgery gains popularity, it becomes crucial to understand complications associated with the procedure. The potential complications of laparoscopy include those related to laparoscopy and those related to the surgical procedure. As new applications for laparoscopic surgery emerge, it is important for the surgeon to become familiar with potential complications.

Diagnosis and surgical repair of patellar luxations in a flock of sheep

Eleven sheep with a common ancestry were evaluated for clinical signs of hind limb lameness. Physical examination revealed advanced forms of patellar luxation. Radiography confirmed the diagnosis of patellar luxation; flexed dorsoproximal-dorsodistal radiographic views were obtained and revealed hypoplasia of the femoral trochlea. Because of the advanced form of patellar luxation and trochlear hypoplasia, surgical intervention was recommended in the form of recession trochleoplasty and a modified tibial tuberosity transposition, along with imbrication and releasing incisions. Sheep may have a genetic predisposition for patellar luxation.