Construct Validity and Possible Educational Role for Motion Analysis in a Laparoscopic Trainer

Maeve O’Neill Trudeau, MD, Ahmed Nasr, MD, FRCSC, Brian Carrillo, PhD, J. Ted Gerstle, MD, FRCSC, FACS, FAAP, Georges Azzie, MD, FRCSC. Dept of Surgery, University of Toronto, Toronto ON Canada. Centre for Image Guided Innovation & Therapeutic Intervention, Hospital for Sick Children, Toronto. Dept of Surgery, University of Ottawa, Children’s Hospital of Eastern Ontario, Ottawa ON Canada.

Introduction
Laparoscopic models for ex vivo upskilling are becoming increasingly important components of surgical education. This study aims to establish the construct validity and possible educational role of a new, low-cost laparoscopic box trainer program equipped with motion sensors at the trocar insertion ports.

Methods and Procedures
The simulator was fitted with custom-built motion tracking hardware and software. Participants were recruited at the Education Booth of the 2012 combined SAGES/IPEG meeting, and were stratified into novice, intermediate and expert groups. They were asked to perform a defined intra-corporeal suturing task. Velocity, acceleration and range were studied in all degrees of freedom available during laparoscopic surgery (Pitch, Yaw, Roll and Surge).

Results
We had a total of 64 participants (14 novices, 19 intermediates and 31 experts). Our laparoscopic simulator was able to discriminate between levels of expertise in the four degrees of freedom using the velocity and acceleration (see table below) but not using the range.

Conclusion
Motion tracking analysis enabled us to significantly discriminate between novices, intermediates and experts. The system’s relatively simple technology and low cost may enhance its dissemination and use. This technology may be adapted to create a real-time motion feedback system that can be used for teaching and assessment of MAS skills.