• 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

Does a Surgical Operating Platform Shorten the Learning Curve for Single-incision-laparoscopy?

Erwin Rieder, MD, Matthew Breen, BS, Maria A Cassera, BS, Danny V Martinec, BS, Chet W Hammill, MD, Lee L Swanstrom, MD. MIS Program, Legacy Health, Portland, OR; Gastrointestinal and Minimally Invasive Surgery, The Oregon Clinic, Portland, OR

 

Objective: In single-incision-laparoscopy (SIL), crossed instruments together with the proximity of the endoscope inevitably interferes with smooth movements, and has been shown to be more mentally demanding than the standard laparoscopic approach (SL). Novel developments such as triangulating operating platforms, aim to overcome these drawbacks and provide true right/left manipulation. However, due to the novelty of this surgical approach, the required learning curve to reach proficiency might be even more challenging. The aim of this study was to compare the early learning curve of a single-port surgical-platform (SPSP) with that of SIL and SL.
Methods and procedures: Six participants with different laparoscopic experience levels (naïve, intermediate, expert) were tested with a validated intracorporeal suturing task (FLS) performed with either a SPSP (Spider-System), or a SIL-approach with crossed/articulating instruments. SL served as the control. During a 4-week training period (two sessions/week), suture performances with the three different techniques were assessed. All sutures were evaluated using FLS-scoring methods for suturing. A previously defined level of proficiency (two consecutive proficient suture scores at or above 93.7, followed by 10 non-consecutive proficient sutures) was used. After each individual session, participants rated their related subjective mental workload by a validated tool (NASA-TLX).
Results: Within the four-week training period it was observed that, compared to the SIL approach, a significantly higher number of proficient sutures were achieved with the SPSP (9.7% vs. 18.0%, p=0.041). However, both were significantly lower than the number achieved with SL (87.5%; p<0.01). No participant obtained the pre-defined level of proficiency with the SPSP or SIL.
The experts, who were proficient in laparoscopic suturing, achieved a median of 9 sutures (37.5%) with the SPSP, at or above the proficiency score. Only a median of 5 sutures at this level were accomplished with the SIL approach (21%).
Although the intermediate group was also found to be proficient in standard laparoscopic suturing, each participant achieved only 2 successful attempts with SIL and a median of 2.5 (range: 0 to 5) proficient sutures with the SPSP.
None of the novices accomplished a proficiency score ≥ 93.7 with the SIL approach. With the SPSP, one naïve participant achieved three proficient sutures. Interestingly, even without any previous surgical experience, naïve participants easily achieved proficiency with SL during the 4 weeks.
Evaluating the best individual scores achieved with the SPSP and SIL, a residual median performance gap of 15% (range: 9% to 25%) to SL was observed.
Mental workload of the experts decreased during the SPSP and SIL training and were finally comparable to the level of SL (score of less then 30). On the other hand, the less experienced participants still indicated a higher mental workload for SPSP and SIL.
Conclusion: Compared to SIL with crossed instruments, a surgical operating platform appears to be beneficial in shortening the early learning curve of single port surgery. However, performance with SPSP or SIL seems to be significantly less intuitive than SL. Additionally, after the 4-week training-period a performance gap to SL remained when a SPSP- or SIL-approach was used.

 


Session Number: Poster – Poster Presentations
Program Number: P161
View Poster

82

Share this:

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

Related

« Return to SAGES 2012 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