Construct validation of the ProMIS simulator using a novel laparoscopic suturing task

Sickle, Kent R. Van; McClusky, David A.; Gallagher, Anthony G.; Smith, C. Daniel

doi:10.1007/s00464-004-8274-6

Cited by 149 publications

(89 citation statements)

References 15 publications

(15 reference statements)

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“…In laparoscopic surgery, however, it has been proved that this is not always the case [58]. Motion smoothness is also reported as a determining factor for manipulation tasks, such as those involving object grasping, transfer, cutting, or suturing [25,26,46]. Other motion metrics relate to the trainee's mastery of the task space, in terms of dimensions and orientation.…”

Section: Clinical Definition Of Metricsmentioning

confidence: 99%

“…The concept is not new, and has already been exploited in the ProMIS simulator (Haptica, Dublin, Ireland). Tracking 3D movements of MIS instruments in the ProMIS requires two cameras for stereoscopic visión [25]. The challenge, however, is to do the same thing using 2D information obtained using one camera only (endoscope).…”

Section: Human Motíon Tracking In Real Settíngsmentioning

confidence: 99%

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Methods and Tools for Objective Assessment of Psychomotor Skills in Laparoscopic Surgery

García

Sánchez-González

Lamata

et al. 2011

Journal of Surgical Research

131

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Training and assessment paradigms for laparoscopic surgical skills are evolving from traditional mentortrainee tutorship towards structured, more objective and safer programs. Accreditation of surgeons requires reaching a consensus on metrics and tasks used to assess surgeons' psychomotor skills. Ongoing development of tracking systems and software Solutions has allowed for the expansión of novel training and assessment means in laparoscopy. The current challenge is to adapt and include these systems within training programs, and to exploit their possibilities for evaluation purposes. This paper describes the state of the art in research on measuring and assessing psychomotor laparoscopic skills. It gives an overview on tracking systems as well as on metrics and advanced statistical and machine learning techniques employed for evaluation purposes. The later ones have a potential to be used as an aid in deciding on the surgical competence level, which is an important aspect when accreditation of the surgeons in particular, and patient safety in general, are considered. The prospective of these methods and tools make them complementary means for surgical assessment of motor skills, especially in the early stages of training. Successful examples such as the Fundamentáis of Laparoscopic Surgery should help drive a paradigm change to structured curricula based on objective parameters. These may improve the accreditation of new surgeons, as 1 To whom correspondence and reprint requests should be addressed at Bioengineering and Telemedicine Centre (GBT), ETSI Telecomunicación, Universidad Politécnica de Madrid (UPM). Avda Complutense, 30, 28040, Madrid, Spain. E-mail: ioropesa@gbt.tfo. upm.es. well as optimize their already overloaded training schedules.

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Section: Clinical Definition Of Metricsmentioning

confidence: 99%

Section: Human Motíon Tracking In Real Settíngsmentioning

confidence: 99%

Methods and Tools for Objective Assessment of Psychomotor Skills in Laparoscopic Surgery

García

Sánchez-González

Lamata

et al. 2011

Journal of Surgical Research

131

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“…A structured approach to this process has long been developed in other industries and has been applied extensively in laparoscopic surgery by Schijven et al [6,[11][12][13][14][15]. In accordance with this methodology, a number of basic skills trainers and complex task trainers have been validated to various degrees: Procedicus MIST (Mentice) [7,17], LapSim (Surgical Science) [21], and Promis (Haptica) [2,19]. These simulators are designed to teach basic skills like holding, grasping, moving, cutting, and diathermy and in some cases also to teach complex tasks such as knot-tying and dissection.…”

Section: Motivation For This Studymentioning

confidence: 99%

Face validation of the Simbionix LAP Mentor virtual reality training module and its applicability in the surgical curriculum

et al. 2007

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Background: The goal of our study was to determine expert and referent face validity of the LAP Mentor, the first procedural virtual reality (VR) laparoscopy trainer. Methods: In the Netherlands 49 surgeons and surgical trainees were given a hands-on introduction to the Simbionix LAP Mentor training module. Subsequently, a standardized five-point Likert-scale questionnaire was administered. Respondents who had performed over 50 laparoscopic procedures were classified as ''experts.'' The others constituted the ''referent'' group, representing nonexperts such as surgical trainees. Results: Of the experts, 90.5% (n = 21) judge themselves to be average or above-average laparoscopic surgeons, while 88.5% of referents (n = 28) feel themselves to be less-than-average laparoscopic surgeons (p = 0.000). There is agreement between both groups on all items concerning the simulatorÕs performance and application. Respondents feel strongly about the necessity for training on basic skills before operating on patients and unanimously agree on the importance of procedural training. A large number (87.8%) of respondents expect the LAP Mentor to enhance a traineeÕs laparoscopic capability, 83.7% expect a shorter laparoscopic learning curve, and 67.3% even predict reduced complication rates in laparoscopic cholecystectomies among novice surgeons. The preferred stage for implementing the VR training module is during the surgeonÕs residency, and 59.2% of respondents feel the surgical curriculum is incomplete without VR training. Conclusion: Both potential surgical trainees and trainers stress the need for VR training in the surgical curriculum. Both groups believe the LAP Mentor to be a realistic VR module, with a powerful potential for training and monitoring basic laparoscopic skills as well as full laparoscopic procedures. Simulator training is perceived to be both informative and entertaining, and enthusiasm among future trainers and trainees is to be expected. Further validation of the system is required to determine whether the performance results agree with these favorable expectations.Key words: Training/courses -CholecystectomyEducation -Endoscopy -Imaging -Virtual realityThe apprenticeship model is historically used to teach surgery. In essence it consists of future surgeons training on actual patients in the operating room (OR). The apprenticeÕs inexperience results in prolonged OR time, incurring higher costs and higher risks of peroperative complications. In part, this phenomenon can be compensated for by training sufficiently preoperatively [1].The practice of training residents in real ORs also hinders the learning process itself by compromising educational opportunities: The learning environment is stressful and learning opportunities are as unpredictable as the availability of the patients on which to practice. Consequently, learning laparoscopy is an opportunistic enterprise. Until recently we lacked viable alternatives for surgical training beyond short introductory courses. Consequently, we had to tolerate...

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“…Los resultados respecto al grupo de cirujanos con experiencia intermedia y expertos mostraron diferencias significativas en la distancia recorrida por el portaagujas durante la subtarea de anudado doble. Sin embargo, no se obtuvieron diferencias significativas respecto el uso del disector, como se describe en los resultados obtenidos en los trabajos de Yamaguchi et al 27 , van Sickle et al 28 o en el presente estudio. Por consiguiente, esto nos lleva a pensar que, además del tiempo de ejecución de la tarea, la distancia recorrida por los instrumentos es un factor presente en la mayoría de los estudios que analizan la sutura laparoscópica y que sería conveniente ampliar la muestra de estudio para poder establecer de forma más precisa qué instrumental (disector, portaagujas o ambos) es determinante en la diferenciación del nivel de habilidad técnica entre cirujanos para esta tarea.…”

Section: Discussionunclassified

Utilidad de un sistema de seguimiento óptico de instrumental en cirugía laparoscópica para evaluación de destrezas motoras

Sánchez‐Margallo

Pagador

et al. 2014

Cirugía Española

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RESUMENIntroducción: En este trabajo se estudia la utilidad de un sistema de evaluación de destrezas quirúrgicas basado en el análisis de los movimientos del instrumental laparoscópico. Método: El sistema consta de un simulador físico laparoscópico y un sistema de seguimiento y evaluación de habilidades técnicas quirúrgicas. En el estudio han participado 6 cirujanos con experiencia intermedia (entre 1 y 50 intervenciones laparoscópicas) y 5 cirujanos expertos (más de 50 intervenciones laparoscópicas), todos ellos con la mano derecha como dominante. Cada sujeto realizó 3 repeticiones de una tarea de corte con la mano derecha en tejido sintético, una disección de la serosa gástrica y una sutura en la disección realizada. Para cada ejercicio se analizaron los parámetros de tiempo, distancia recorrida, velocidad, aceleración y suavidad de movimientos para los instrumentos de ambas manos.Resultados: En la tarea de corte, los cirujanos expertos muestran menor aceleración (p = 0,014) y mayor suavidad en los movimientos (p = 0,023) en el uso de la tijera. Respecto a la actividad de disección, los cirujanos expertos requieren menos tiempo (p = 0,006) y recorren menos distancia con ambos instrumentos (p = 0,006 para disector y p = 0,01 para tijera). En la tarea de sutura, los cirujanos expertos presentan menor tiempo de ejecución que los cirujanos de nivel intermedio (p = 0,037) y recorren menos distancia con el disector (p = 0,041). Conclusiones: El sistema de evaluación se mostró útil en las tareas de corte, disección y sutura, y constituye un progreso en el desarrollo de sistemas avanzados de entrenamiento y evaluación de destrezas quirúrgicas laparoscópicas. Usefulness of an optical tracking system in laparoscopic surgery for motor skills assessmentABSTRACT Introduction: The objective of this study is to assess the usefulness of an evaluation system of surgical skills based on motion analysis of laparoscopic instruments. Method: This system consists of a physical laparoscopic simulator and a tracking and assessment system of technical skills in laparoscopy. Six surgeons with intermediate experience (between 1 and 50 laparoscopic surgeries) and 5 experienced surgeons (more than 50 laparoscopic surgeries) took part in this study. All participants were right-handed. The subjects performed 3 repetitions of a cutting task on synthetic tissue with the right hand, dissection of a gastric serous layer, and a suturing task in the dissection previously done. Objective metrics such as time, path length, speed of movements, acceleration and motion smoothness were analyzed for the instruments of each hand. Results: In the cutting task, experienced surgeons show less acceleration (P=.014) and a smoother motion (P=.023) using the scissors. Regarding the dissection activity, experienced surgeons need less time (P=.006) and less length with both instruments (P=.006 for dissector and P=.01 for scissors). In the suturing task, experienced surgeons require less time (P=.037) and distance travelled (P=.041) by the dissector. Conclusions: ...

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Construct validation of the ProMIS simulator using a novel laparoscopic suturing task

Cited by 149 publications

References 15 publications

Methods and Tools for Objective Assessment of Psychomotor Skills in Laparoscopic Surgery

Methods and Tools for Objective Assessment of Psychomotor Skills in Laparoscopic Surgery

Face validation of the Simbionix LAP Mentor virtual reality training module and its applicability in the surgical curriculum

Utilidad de un sistema de seguimiento óptico de instrumental en cirugía laparoscópica para evaluación de destrezas motoras

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