Yusuke Watanabe, MD1, Yo Kurashima, MD1, Elif Bilgic, MSc2, Saseem Poudel, MD1, Tomoko MIzota, MD1, Shinichiro Yokohama, MD1, Toshiaki Shichinohe, MD1, Satoshi Hiring, MD1. 1Department of Gastroenterological surgery II, Hokkaido University Graduate School of Medicine, 2Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre
Introduction: The Fundamentals of Laparoscopic Surgery (FLS) program has successfully been used to teach and assess basic skills required to perform laparoscopic surgery. The more popular the FLS became, the score difference between surgeons and surgical trainees has been less significant. The purpose of this pilot study was to evaluate the impact of adding fragility to the FLS tasks’ models on the accuracy of assessing laparoscopic skills.
Methods: Minimally invasive surgeons (MIS) and general surgeons/surgical trainees (GS) completed modified FLS tasks; the peg transfer (PEG) task and the intracorporeal suturing (ICS) task, in addition to the original two tasks. The agar-based pegs were used for the modified PEG task and Kimwipes wipers (non-woven papers) were used instead of penrose drains for the ICS task. For the original tasks, scores were calculated based on the standard FLS scoring system (time and accuracy). In addition to the accuracy component of the standard scoring system, the degree of damages to the modified tasks was scored. Scores were compared between the MIS group and GS group using Wilcoxon signed-rank test. The correlation between modified task scores and original task scores was estimated using Spearman’s correlation coefficient. Data are expressed as median score and interquartile range.
Results: A total of 11 subjects (5 MIS, 6 GS) completed the tasks (mean age 36; 82% male). The MIS and GS groups scored 250[213; 257] vs. 232[214; 239] (p=0.41) on the original PEG task and 515[440; 537] vs. 449[400; 480] (p=0.17) on the original ICS task. The time scores and accuracy scores on the original tasks had no significant difference between the groups. Compared to the GS group, the MIS group had significantly greater scores on modified tasks (PEG 103[40; 144] vs. 0[0; 8], p=0.01 and ICS 494[446; 526] vs. 430[383; 452], p=0.04). The differences in performances were due to better scores for the MIS group on the time and accuracy scores of the PEG task (time p= 0.01, accuracy p= 0.04) and the accuracy scores of the ICS task (p= 0.03). While modified ICS task scores correlated strongly with original task scores (r=0.93, p< 0.001), there was no significant correlation between scores on the PEG task.
Conclusions: The preliminary data shows that adding another component to the FLS scoring system can improve the accuracy of assessing laparoscopic skills. Increasing the fragility of the models could take the FLS manual skills assessment to the next level.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79792
Program Number: P285
Presentation Session: Poster (Non CME)
Presentation Type: Poster