Force feedback vessel ligation simulator in knot-tying proficiency training

Hsu, Justin L.; Korndorffer, James R.; Brown, Kimberly M.

doi:10.1016/j.amjsurg.2015.09.009

Cited by 14 publications

(9 citation statements)

References 13 publications

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“…Selecting a knot that can be repeatedly and correctly constructed in a deep body cavity has the potential to improve the clinical outcomes of patients, as failure of knots can directly contribute to severe, life-threatening postoperative complications. [16][17][18][19][20] An effective surgical knot must have both knot security and loop security. 21 Our study design quantified the mechanism of knot failure and the microscopic knot configuration as proxies for knot security.…”

Section: Discussionmentioning

confidence: 99%

Comparison of knot-tying proficiency and knot characteristics for square and reversing half hitch alternating-post surgical knots in a simulated deep body cavity among novice medical students

Yeung

Sykes³

et al. 2018

cjs

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Background: Proficiency-based knot-tying curricula have been developed for square knots for medical students, but, to our knowledge, no such curriculum exists for the reverse half hitch alternating-post (RHAP) knot. We aimed to compare medical students' knot-tying proficiency, knot-tying self-confidence and final knot characteristics for RHAP and square knots in a simulated deep body cavity. Methods: We performed a within-subject prospective crossover study of novice medical students who received 30 minutes of training in tying both RHAP and square knots. Participant performance was assessed via a knot-tying checklist, and knot configuration, tensile strength, tightness (loop circumference) and mechanism of failure were also assessed. Participants' self-reported confidence in knot tying was captured. Results: Twenty-one students participated in the study. Mean scores on the knottying checklist were significantly higher for RHAP knots than for square knots (6.9 [standard deviation (SD) 2.1] v. 5.2 [SD 2.3], p < 0.01), and RHAP knots were significantly tighter than square knots (46.8 mm [SD 0.4 mm] v. 49.3 mm [SD 0.7 mm], p < 0.05). There were no differences between RHAP and square knots in correct knot configuration, breaking strength or mechanism of failure. Reverse half hitch alternating-post knots were easier to tie within a deep-body cavity, whereas square knots were easier to learn. Conclusion: Novice medical students were more proficient in tying RHAP knots than square knots in a simulated deep body cavity. Students were able to construct RHAP knots more securely and reported increased confidence in tying RHAP knots at depth compared to square knots.

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Section: Discussionmentioning

confidence: 99%

Comparison of knot-tying proficiency and knot characteristics for square and reversing half hitch alternating-post surgical knots in a simulated deep body cavity among novice medical students

Yeung

Sykes³

et al. 2018

cjs

View full text Add to dashboard Cite

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“…Ten of the seventeen studies were conducted in the USA, [35,36,37,38,39,40,41,42,43,44] four in Canada, [45,46,47] three in the UK [48,49,50] and one in Belgium. [51] A range of surgical procedures were examined, the most common being endoscopic [37,40,46,49,50,52], including joint arthroscopy, laparoscopy and hysteroscopy. There were a mix of study designs with six described as prospective randomised control trials (RCT).…”

Section: Study Context and Designmentioning

confidence: 99%

“…Two studies compared the outcomes of trainee surgeons with expert surgeons. [37,44] Three studies did not have a control or comparison group. [4242, 43,45] The evaluation of methodological quality (MERSQI) across the included studies is presented in Table 1.…”

Section: Study Context and Designmentioning

confidence: 99%

“…surgeon. [36,37,39,40,41,43,44,45,46,49,50,52] The ratio between supervisor and trainee surgeon varied from 1:1 to 1:25, i.e. one-to-more than one trainee, across these studies.…”

Section: Study Context and Designmentioning

confidence: 99%

“…[38,39,40,48,52] The remaining twelve described a traditional approach where participants received the same number of turns or duration on the simulator. [36,37,41,42,43,44,45,46,47,49,50,51] The frequency and duration of training varied between studies. Four studies provided massed practice within a single training session [36,38,41,46] whereas the other thirteen studies provided distributed practice across multiple sessions over a longer period of time.…”

Section: Study Context and Designmentioning

confidence: 99%

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