Development of a Model for the Acquisition and Assessment of Advanced Laparoscopic Suturing Skills Using an Automated Device

Bilgiç, Elif; Takao, Madoka; Kaneva, Pepa; Endo, Satoshi; Takao, Toshitatsu; Watanabe, Yusuke; McKendy, Katherine M.; Feldman, Liane S.; Vassiliou, Melina C.

doi:10.1177/1553350618764221

Cited by 5 publications

(6 citation statements)

References 12 publications

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“…6,[13][14][15][16] There have been emerging studies for developing new models for advanced laparoscopic tasks which included continuous suturing with free needle and the Endo Stitch TM device. 6,7 There are still very limited low-cost validated solutions which utilize the widely available trainer box for laparoscopic intracorporeal continuous suturing. Given the importance and significant implications of graduating general surgery residents proficient in continuous laparoscopic suturing, we feel there is more room for study, with only a few papers addressing continuous suturing simulation and methods of assessment.…”

Section: Discussionmentioning

confidence: 99%

“…Bilgic et al have also examined the task of continuous suturing, however, this model used the Endo Stitch TM device which is not readily available to all trainees and surgeons. 7 The aggregate performance score in this study was created in order to provide a benchmark for future research on this model. Minimizing accuracy penalties is an important consideration independent of time required for gaining proficiency in laparoscopic continuous suturing.…”

Section: Discussionmentioning

confidence: 99%

“…Bilgic et al have also examined the task of continuous suturing, however, this model used the Endo Stitch TM device which is not readily available to all trainees and surgeons. 7…”

Section: Discussionmentioning

confidence: 99%

“…6 To detect a similar difference with an α of .05 and power of 80%, with 2-sided testing, 8 participants per group will be required. 7…”

Section: Sample Sizementioning

confidence: 99%

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Pilot Evaluation of a Novel, Low-Cost, Simulation Model for Training and Assessment of Laparoscopic Intracorporeal Continuous Suturing

et al. 2022

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Background: Laparoscopic intracorporeal continuous suturing is being employed in a growing number of minimally invasive procedures. However, there is a lack of adequate bench models for gaining proficiency in this complex task. The purpose of this study was to assess a novel simulation model for running suture. Methods: Participants were grouped as novice (LSN) or expert (LSE) at laparoscopic suturing based on prior experience and training level. A novel low-cost bench model was developed to simulate laparoscopic intracorporeal continuous closure of a defect. The primary outcome measured was time taken to complete the task. Videos were scored by independent raters for Global Operative Assessment of Laparoscopic Skills (GOALS). Results: Sixteen subjects (7 LSE and 9 LSN) participated in this study. LSE completed the task significantly faster than LSN (430 ± 107 vs 637 ± 164 seconds, P ≤ .05). LSN scored higher on accuracy penalties than LSE (Median 30 vs 0, P ≤ .05). Mean GOALS score was significantly different between the 2 groups (LSE 20.64 ± 2.64 vs LSN 14.28 ± 1.94, P < .001) with good inter-rater reliability (ICC ≥ .823). An aggregate score using the formula: Performance Score = 1200-time(sec)-(accuracy penalties x 10) was significantly different between groups with a mean score of 741 ± 141 for LSE vs 285 ± 167 for LSN ( P < .001). Conclusion A novel bench model for laparoscopic continuous suturing was able to significantly discriminate between laparoscopic experts and novices. This low-cost model may be useful for both training and assessment of laparoscopic continuous suturing proficiency.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Bilgic et al have also examined the task of continuous suturing, however, this model used the Endo Stitch TM device which is not readily available to all trainees and surgeons. 7…”

Section: Discussionmentioning

confidence: 99%

“…6 To detect a similar difference with an α of .05 and power of 80%, with 2-sided testing, 8 participants per group will be required. 7…”

Section: Sample Sizementioning

confidence: 99%

See 2 more Smart Citations

Pilot Evaluation of a Novel, Low-Cost, Simulation Model for Training and Assessment of Laparoscopic Intracorporeal Continuous Suturing

et al. 2022

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“…A gap is also evident from our data; all participants stated that training for ALP skills happen mostly in the OR, with lack of effective resources available for learning outside of the OR. Although some advanced LS tasks have been developed with preliminary validity evidence, [21][22][23][24][25] needs assessments were not detailed to optimally define the key skills required to perform ALP, in order to guide the development of an advanced laparoscopy simulation program.…”

Section: Discussionmentioning

confidence: 99%

Defining the key skills required to perform advanced laparoscopic procedures: a qualitative descriptive study

et al. 2020

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Background Simulation is widely used to teach and assess fundamental laparoscopic skills; however, program directors have reported that current simulation programs do not meet the needs for trainees and surgeons learning advanced laparoscopic procedures (ALP). The purpose of our study was to identify the key skills required to perform ALP, to serve as the basis to establish an advanced laparoscopic skills training program. Methods Semi-structured interviews were conducted with attending surgeons, fellows, and senior residents in general surgery, gynaecology, and urology. The questions were developed through an iterative process using relevant literature, expert opinions, and in consultation with a qualitative researcher. Interviews were conducted in person, over the phone, or by videoconference, and inductive thematic analysis was performed. Results 25 interviews were conducted with 16 attending surgeons and 9 fellows/residents from 9 institutions in Canada and USA. Twenty-one skills were identified to be important when performing ALP. The skills most commonly described by faculty were the following : (a) suturing, (b) dissection, (c) procedural expertise, (d) retraction and exposure, and (e) familiarity with relevant anatomy as viewed through the laparoscope. The skills most commonly described by trainees were the following: (a) suturing, (b) dissection, (c) procedural expertise, (d) trocar positioning, and (e) patient factors. There was a large difference between the importance the faculty attributed to the 'Retraction and Exposure' skill compared to the trainees. Conclusion This study identified key skills that are important when performing ALP. In order to address the current needs of trainees/surgeons learning ALP, this work provides the building blocks for the development of an advanced laparoscopic surgery simulation program.

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Construct Validity of a Novel Assessment System for Laparoscopic Suture Accuracy Based on Stereoscopy

Chen

Luo

et al. 2023

World j. surg.

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Background An accurate and objective measuring tool is lacking for laparoscopic suture accuracy assessment in simulation training. We designed and developed the suture accuracy testing system (SATS) and aimed to determine its construct validity in this study. Methods Twenty laparoscopic experts and 20 novices were recruited to perform a suturing task in three sessions using traditional laparoscopic instruments (Tra. session), a handheld multi-degree-of-freedom (MDoF) laparoscopic instrument (MDoF session) and a surgical robot (Rob. session), respectively. The needle entry and exit errors were calculated using the SATS and compared between the two groups.Results No significant difference of the needle entry error was found in all comparisons. As for the needle exit error, the value of the novice group was significantly higher than that of the expert group in Tra. session (3.48 ± 0.61 mm vs. 0.85 ± 0.14 mm; p = 1.451e-11) and MDoF session (2.65 ± 0.41 mm vs. 1.06 ± 0.17 mm; p = 1.451e-11) but not in Rob. session (0.51 ± 0.12 mm vs. 0.45 ± 0.08 mm; p = 0.091). Conclusions The SATS demonstrates construct validity. Surgeons' experience in conventional laparoscopic instruments could be transferred to the MDoF instrument. Surgical robot helps to improve suture accuracy and may bridge the experience gap between laparoscopic experts and novices in basic exercises.

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Development of a Model for the Acquisition and Assessment of Advanced Laparoscopic Suturing Skills Using an Automated Device

Abstract: This study provides validity evidence for the task as a measure of laparoscopic suturing skill using an automated suturing device. It could help trainees acquire the skills they need to better prepare for clinical learning.

Cited by 5 publications

References 12 publications

Pilot Evaluation of a Novel, Low-Cost, Simulation Model for Training and Assessment of Laparoscopic Intracorporeal Continuous Suturing

Pilot Evaluation of a Novel, Low-Cost, Simulation Model for Training and Assessment of Laparoscopic Intracorporeal Continuous Suturing

Defining the key skills required to perform advanced laparoscopic procedures: a qualitative descriptive study

Construct Validity of a Novel Assessment System for Laparoscopic Suture Accuracy Based on Stereoscopy

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