Effect of two instrument designs on laparoscopic skills performance.

OBJECTIVE: To determine whether laparoscopic skills performance is affected by instrument design. STUDY DESIGN: Randomized crossover study. SAMPLE POPULATION: Veterinarians (n = 14) with variable laparoscopic experience. METHODS: Laparoscopic skills performance was assessed with the McGill Inanimate System for Training and Evaluation of Laparoscopic Skills (MISTELS). Participants performed 3 MISTELS tasks twice during 2 sessions (4 tests total). Each set of instruments (set A, B) was used once during each session, and instrument order was switched between the first and second sessions. Surgeons were randomly allocated to either the AB-BA or the BA-AB sequence in a balanced fashion. Scores were compared between instrument sets A and B. RESULTS: Overall, participants performed better when using set A compared with set B. This difference was most striking in the pattern-cutting task (which used scissors and graspers), less convincing in the peg transfer task (which used 2 graspers), and nonexistent in the ligature loop task (which used 1 grasper and 1 pretied ligature loop). CONCLUSIONS: Laparoscopic skills performance, as assessed by MISTELS testing, is affected by instrument design.