58
This suturing task requires trainees to place a simple stitch through two marks in
a longitudinally slit Penrose drain as shown in Fig. 5.5. Trainees are then required
to tie the suture extra corporeally, using a knot-pushing device to slide the knot
down. They must tie the knot tightly enough to close the slit in the drain, being care-
ful not to avulse the drain off the foam block. At least three square throws are
required to ensure that the knot will not slip under tension. The required proficiency
score is 136 s with up to 1 mm accuracy error; no knot security errors (slippage) are
allowed. Proficiency scores must be achieved on 2 consecutive repetitions and on 10
additional (nonconsecutive is acceptable) repetitions.
This suturing task requires trainees to place a suture precisely through two marks
on a Penrose drain that has been slit along its long axis as shown in Fig. 5.6. Trainees
are then required to tie the knot using an intracorporeal knot. They must place at
least three throws that must include one double throw and two single throws on the
suture and must also ensure the knots are square and won’t slip. Between each throw
Fig. 5.3 Task 2: Pattern
cut (Fundamentals of
Laparoscopic Surgery®
(FLS) Program is owned
by Society of American
Gastrointestinal and
Endoscopic Surgeons and
American College of
Surgeons. Images used
with permission)
Fig. 5.4 Task 3:
Placement and securing of
ligating loop (endoloop)
(Fundamentals of
Laparoscopic Surgery®
(FLS) Program is owned
by Society of American
Gastrointestinal and
Endoscopic Surgeons and
American College of
Surgeons. Images used
with permission)
E.I. George et al.