• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy-Coming Soon!
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

Characteristics and precision of needle driving for right-handed pediatric surgeons comparing right and left driving using a model of infant laparoscopic diaphragmatic hernia repair

Shun Onishi, MD, Motoi Mukai, MD, PhD, Takamasa Ikee, MD, Koji Yamada, MD, Takafumi Kawano, MD, Waka Yamada, MD, Ryuta Masuya, MD, Seirou Machigashira, MD, Kazuhiko Nakame, MD, Tatsuru Kaji, MD, PhD, Satoshi Ieiri, MD, PhD, FACS. Department of Pediatric Surgery, Kagoshima University

PURPOSE: Late-presenting diaphragmatic hernia is treated by both thoracoscopic and laparoscopic approaches. In cases with no herniation of the spleen into the thoracic cavity, a laparoscopic approach is easier for repairing the diaphragm because of no costal restriction and a more spacious working space compared with the thoracic approach. In a laparoscopic approach, left needle driving is better than right driving for a few reasons;1) the right hand port is too close to the defect of the diaphragm, 2) left needle driving uses co-axial suturing while right driving uses para-axial suturing. (Fig. 1a). This study aimed to verify the characteristics and precision of needle driving for right-handed pediatric surgeons comparing right (Rt) and left (Lt) needle driving using an infant laparoscopic diaphragmatic repair model simulator.

METHODS: We developed a model of a 1-year-old infant body (body weight: 10 kg) based on computed tomography data. The pneumoperitoneum was reproduced based on the clinical situation. A detachable diaphragmatic defect (Bochdalek hernia, 3.0 × 1.5 cm), stomach, liver and spleen were made of styrene and placed in this model (Fig. 1b). The examinees were 18 pediatric surgeons. The task required the examinee to perform needle driving three times without any knot tying. They were all right-handed and had to perform the technique with both hands (Fig. 2a and 2b). We evaluated the required time and conducted an image analysis (suturing balance and the gap of the suturing interval; the results of these assessments determined that a smaller gap was superior, Fig. 2c). Additionally, we evaluated the total path length, velocity, and acceleration of needle driver using a three-dimensional position measurement instrument with an electromagnetic tracking system (TrackStar, Northern Digital Inc., Ontario, Canada). A statistical analysis was performed using the two-tailed paired and unpaired t-tests, and a value of p < 0.05 was considered to be statistically significant.

RESULTS: Table 1 shows the findings for the required time (sec, Rt: 310.78 ± 148.93 vs. Lt: 308.61 ± 122.53, p = 0.93), suture balances (1st, Rt: 1.59 ± 1.13 vs. Lt: 1.88±1.84, p = 0.564, 2nd, Rt: 1.4 ± 1.02 vs. Lt: 1.65 ± 1.81, p = 0.614, 3rd, Rt: 2.24 ± 1.46 vs. Lt: 1.52 ± 1.28, p = 0.150), the gap of the suturing interval (Rt: 1.2 ± 0.93vs Lt: 2.17 ± 1.67, p = 0.036), total path length (mm, Rt: 594.03 ± 205.29 vs. Lt: 1641.07 ± 670.68, p = 0.0000018), velocity (mm/sec, Rt: 1.92 ± 0.54 vs. Lt: 5.3 ± 1.39, p=0.0000000066), and acceleration (mm/sec2, Rt: 13.6 ± 15.84 vs. Lt: 63.66 ± 62.8, p = 0.0031).

CONCLUSION: There were no significant differences in the required time and suture precision without any gap in the suturing interval. For right-handed pediatric surgeons, left needle driving showed fast but not economical movement, implying rough and risky forceps manipulation in a small working space, such as in neonates and infant patients. Given these results, non-dominant hand training is necessary in advanced pediatric endo-surgery to avoid organ injury due to fast and excessive forceps manipulation.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 84296

Program Number: ETP754

Presentation Session: Emerging Technology Poster

Presentation Type: Poster

127

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2017 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Critical View of Safety (CVS) Challenge QR Code

The SAGES Critical View of Safety Challenge – Donate Your Lap Chole Videos!

The Society of American Gastrointestinal and Endoscopic Surgeons is hosting the first Artificial Intelligence Data Challenge conducted by surgeons. The aim of this challenge is to generate a large and diverse dataset of laparoscopic cholecystectomy videos, annotated with respect to the subcomponents of the Critical View of Safety (CVS). Computer scientists from all over the […]

Respuesta de SAGES al Estudio NordICC sobre el beneficio de las colonoscopias de detección

SAGES desea aclarar los resultados del estudio NordICC y colocarlos en contexto de los esfuerzos de varias agencias nacionales para reducir el riesgo de cáncer colorrectal – la segunda causa de muerte por cáncer más frecuente en los Estados Unidos-, mediante la promoción de la detección y tratamiento oportuno de las lesiones.

SAGES Response to NordICC Study Regarding Benefit of Screening Colonoscopies

The NordICC Study recently published in The New England Journal of Medicine and widely reported on by media outlets has raised questions regarding the benefit of screening colonoscopy in lowering the risk of colorectal cancer and cancer-related deaths among otherwise healthy and symptom-free men and women aged 55 to 64. Provocative headlines and commentaries have […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons