Laparoscopic Suturing as a Barrier to Broader Adoption of Laparoscopic Surgery

Lim, Sangtaeck; Ghosh, Sudip J.; Niklewski, Paul; Roy, Sanjoy

doi:10.4293/jsls.2017.00021

Cited by 39 publications

(28 citation statements)

References 54 publications

(56 reference statements)

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“…No beneficial effects were observed in junior novice surgeons asked to perform part of a laparoscopic cholecystectomy [15], nor in 12 surgeons with varying experience placing laparoscopic knots [10]. Although considered a basic skill, laparoscopic knot tying is reportedly the most difficult laparoscopic skill to master [33,34]. In aforementioned studies, preselected music by the research team was used.…”

Section: Discussionmentioning

confidence: 99%

The effect of preferred music on mental workload and laparoscopic surgical performance in a simulated setting (OPTIMISE): a randomized controlled crossover study

Oomens

Kleinrensink

et al. 2020

Surg Endosc

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Background Worldwide, music is commonly played in the operation room. The effect of music on surgical performance reportedly has varying results, while its effect on mental workload and key surgical stressor domains has only sparingly been investigated. Therefore, the aim is to assess the effect of recorded preferred music versus operating room noise on laparoscopic task performance and mental workload in a simulated setting. Methods A four-sequence, four-period, two-treatment, randomized controlled crossover study design was used. Medical students, novices to laparoscopy, were eligible for inclusion. Participants were randomly allocated to one of four sequences, which decided the exposure order to music and operation room noise during the four periods. Laparoscopic task performance was assessed through motion analysis with a laparoscopic box simulator. Each period consisted of ten alternating peg transfer tasks. To account for the learning curve, a preparation phase was employed. Mental workload was assessed using the Surgery Task Load Index. This study was registered with the Netherlands Trial Register (NL7961). Results From October 29, 2019 until March 12, 2020, 107 participants completed the study, with 97 included for analyzation. Laparoscopic task performance increased significantly during the preparation phase. No significant beneficial effect of music versus operating room noise was observed on time to task completion, path length, speed, or motion smoothness. Music significantly decreased mental workload, reflected by a lower score of the total weighted Surgery Task Load Index in all but one of the six workload dimensions. Conclusion Music significantly reduced mental workload overall and of several previously identified key surgical stressor domains, and its use in the operating room is reportedly viewed favorably. Music did not significantly improve laparoscopic task performance of novice laparoscopists in a simulated setting. Although varying results have been reported previously, it seems that surgical experience and task demand are more determinative.

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Section: Discussionmentioning

confidence: 99%

The effect of preferred music on mental workload and laparoscopic surgical performance in a simulated setting (OPTIMISE): a randomized controlled crossover study

Oomens

Kleinrensink

et al. 2020

Surg Endosc

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“…A learning curve would likely have been even more apparent if trained surgeons were compared with untrained surgeons, but such a study design would not be ethically justifiable because of the well-known challenges of laparoscopic suturing. 7 Some technique refinement also occurred during the initial surgeries performed by the experienced surgeon that could have affected the time required for ligation for this surgeon. These modifications were communicated to the novice surgeons and appeared to streamline the procedure for subsequent surgeries.…”

Section: Discussionmentioning

confidence: 99%

“…However, MIS can be technically difficult to perform and requires specific hands‐on training before surgery can be performed in live animals 5,6 . In particular, laparoscopic suturing and knot tying are considered among the most difficult skills a surgeon can learn and have been postulated to constitute a barrier to the development and adoption of laparoscopic procedures among surgeons in human medicine 7 . This barrier will likely translate into veterinary medicine as more MIS is performed.…”

Section: Introductionmentioning

confidence: 99%

Comparison between intracorporeal and extracorporeal ligations in a laparoscopic ovariectomy model in dogs

et al. 2021

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Objective: To compare the influence of extracorporeal and intracorporeal ligations on the duration of and complications associated with laparoscopic ovariectomy in dogs. Study design: Prospective randomized experimental study. Animals: Healthy intact female dogs (n = 18). Methods: The left and right ovarian pedicles of dogs undergoing laparoscopic ovariectomy were randomly assigned to intracorporeal (n = 18) or extracorporeal (n = 18) ligation groups. Surgeries were performed by two American College of Veterinary Surgeons (ACVS) diplomates and two ACVS residents. The time required to place extracorporeal and intracorporeal ligations, duration of surgery, and intraoperative complications were compared between ligation techniques. Postoperative complications were recorded. Results: The time required for intracorporeal ligation (17.3 ± 8.7 minutes) did not differ from that required for extracorporeal ligation (15.1 ± 6.1 minutes; P = .38). The total duration of surgery was 102.7 ± 28.7 minutes including portal placement and veterinary student closure of incisions. Ligation of the ovarian pedicle was successful in 16 of 17 dogs. Intraoperative hemorrhage occurred in three dogs, and postoperative complications were noted in three dogs, without apparent difference between ligation techniques. Conclusion: No difference was identified between extracorporeal and intracorporeal ligations of ovarian pedicles. Clinical significance: This study does not provide evidence to support one ligation technique rather than the other.

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“…Laparoscopic surgery is a newly developed minimally invasive method and an inevitable trend in the development of future surgical methods [10]. The advantage of laparoscopic radical resection for cholangiocarcinoma treatment is listed as follows:…”

Section: Discussionmentioning

confidence: 99%

Application of Laparoscopic Radical Resection for Type III and IV Hilar Cholangiocarcinoma Treatment

Liu

et al. 2020

Gastroenterology Research and Practice

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Background. This study is aimed at investigating the feasibility and safety of the laparoscopic radical resection for treating type III and IV hilar cholangiocarcinoma (III/IV Hilar C). Methods. Six patients with III/IV Hilar C were enrolled in our hospital. All patients underwent total laparoscopic surgery, including basic surgery (laparoscopic gallbladder, hilar bile duct, and common bile duct resection and hepatoduodenal ligament lymph node dissection) combined with left hepatic and caudate lobe resection/portal resection. The tumor size, operation time, intraoperative blood loss, and postoperative complications were observed. The follow-up of the patients after discharge was recorded. Results. Surgery was successfully completed in 6 patients. We found that the tumor size of 6 patients ranged from 1.5 to 3.6 cm, with 4 lymph nodes. The operation time was 540-660 minutes, and the blood loss was 300-500 ml. One patient developed bile leakage after surgery, healed within 2 weeks after drainage. The postoperative hospital stay was 16 (13-24) days. There were 4 cases of negative bile duct margin tumor, 1 case was positive, and 1 case was not reported. All 6 patients were discharged smoothly without perioperative death. Regular examinations were conducted every 3 months after discharge, and the median duration was 7 months. Only 1 patient had a marginal dysplasia, and 5 patients had no obvious signs of recurrence. Conclusions. Application of laparoscopic radical resection for III/IV Hilar C is safe and feasible and has good short-term efficacy with adequate preoperative evaluation, appropriate case selection, and precise operative strategy.

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Laparoscopic Suturing as a Barrier to Broader Adoption of Laparoscopic Surgery

Cited by 39 publications

References 54 publications

The effect of preferred music on mental workload and laparoscopic surgical performance in a simulated setting (OPTIMISE): a randomized controlled crossover study

The effect of preferred music on mental workload and laparoscopic surgical performance in a simulated setting (OPTIMISE): a randomized controlled crossover study

Comparison between intracorporeal and extracorporeal ligations in a laparoscopic ovariectomy model in dogs

Application of Laparoscopic Radical Resection for Type III and IV Hilar Cholangiocarcinoma Treatment

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