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Surg Endosc. 2012 Dec;26(12):3426-9. doi: 10.1007/s00464-012-2357-6. Epub 2012 May 31.

Data-based self-study guidelines for the fundamentals of laparoscopic surgery examination.

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Gastrointestinal and Minimally Invasive Surgery Division, The Oregon Clinic, 4805 NE Glisan St, Suite 6N60, Portland, OR 97213, USA.



In preparing for the fundamentals of laparoscopic surgery (FLS) exam, residents usually adopt a self-learning strategy where practice time can be managed with more flexibility. However, with this self-learning strategy, there is a lack of direct supervision from experts and residents risk understudying for this high-stakes exam. Our objective is to determine study goals for effective self-guided practice for the FLS manual skills tasks that will result in passing the examination.


FLS manual skills data for all PGY-5 residents during 2009-2010 was supplied by the FLS administrative office. Descriptive statistics were performed, and data were regrouped by the pass/fail results of the exam. The minimum practice time requirement for passing each manual skills task is reported in order to guide practice.


1,047 proctored FLS exams were completed by 2009-2010 residents. Mean task time achieved by all residents was 84 ± 31 s for peg transfer, 139 ± 54 s for pattern cut, 78 ± 29 s for endoloop, 158 ± 66 s for extracorporeal suturing, and 168 ± 77 s for intracorporeal suturing. In the pass group (n = 988), mean time to complete each task was 80 s for peg transfer, 134 s for pattern cut, 75 s for endoloop, 148 s for extracorporeal suturing, and 160 s for intracorporeal suturing. Calculations suggest a self-study goal for each task of 53 s for peg transfer, 50 s for pattern cut, 87 s for endoloop, 99 s for extracorporeal suturing, and 96 s for intracorporeal suturing. If a resident can reliably achieve these results during self-study, they have an 84% chance of passing the exam.


Residents preparing to take the FLS exam can refer to data presented in this study to set practice goals. Referring to these data-based practice goals will help residents to improve their chances of passing this high-stakes exam.

[Indexed for MEDLINE]

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