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

SAGES

Society of American Gastrointestinal and Endoscopic Surgeons

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Committees
      • Descriptions and Video Updates
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Mentors
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • SAGES Mission Statement
    • SAGES Resource Guide
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Distinguished Service
      • Young Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • The Brandeis
      • Advocacy Summit Award
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • SAGES 2019 Meeting Information
    • 2019 Scientific Session Call For Abstracts
    • 2019 Emerging Technology Session Call For Abstracts
    • 2018 Prevent BDI Consensus Conference
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • Leadership Development and Health Policy Conference Videos
      • SAGES Quality Summit Meeting
      • SAGES 2018
      • SAGES 2017
      • SAGES 2016
      • SAGES 2015
      • SAGES 2014
      • SAGES 2013
    • Related Meetings Calendar
  • Membership
    • Join SAGES!
    • Give the Gift of SAGES Membership
    • Membership Benefits
    • Active Membership
    • Allied Health Membership
    • Associate Active Membership
    • Candidate Membership
    • International Membership
    • Medical Student Membership
  • For Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • Find a SAGES Member
  • Publications
    • 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
    • Troubleshooting Guides
  • Education
    • Virtual Hernia Clinic
    • The Safe Cholecystectomy Didactic Modules
    • Masters Series
      • SAGES Masters Program Facebook Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • The SAGES HPB/Solid Organ Program
    • The SAGES Safe Cholecystectomy Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Endorsed Courses
    • SAGES Robotics Fellows Course
    • MIS Fellows Course
    • Free Educational Webinars
    • SMART Enhanced Recovery Program
    • SAGES Quality Initiative
    • SAGES OR SAFETY Video
    • SAGES.TV Video Library
    • SAGES Surgical WIKI
    • iMAGES Image Library
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • SAGES Research Opportunities
    • SAGES Endorsed Courses
    • 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 the Video Library
  • Log In

Laparoscopic Nissen Fundoplication Assessment: Task Analysis as Model for the Development of a Procedural Checklist

Objective: Learning an advanced laparoscopic procedure is a complex process that requires clinical exposure, direct teaching, and deliberate practice. However, expert laparoscopic surgeons automate their knowledge making it difficult to teach all of the incremental steps. The aim of this study was to deconstruct the operative steps of a laparoscopic Nissen fundoplication (LNF) and develop a procedural checklist to be used for resident assessment.

Methods: A behavioral task analysis was conducted with five experts using the Delphi technique to identify all steps of a LNF. The Delphi survey included a video analysis of expert performance, two electronic iterative rounds and a final group interview to reach consensus. The created checklist was then used to assess the performance of 14 general surgery residents (3 R2’s, 6 R3’s, 4 R4’s, 1 R5), all with previous clinical experience on the Foregut Surgery Service. Participants were asked to view an instructional video created prior to the development of the checklist, and complete the procedure on a porcine model. Laparoscope video recordings of resident performance were analyzed using the created procedural checklist by a blinded observer.

Results: Results of the Delphi survey produced a 65 step procedural checklist with four major components (crural dissection, crural closure, fundic mobilization and creation of fundoplication). Thirteen of fourteen participants completed the procedure; 1 pig died during the operation. The median score for all residents who completed the procedure was 31 (range 13-38). The checklist median total score for senior residents (35.5, 34-38) was significantly higher than junior residents (29.5, 13-36)(p=0.0162). All residents were able to demonstrate knowledge of most of the major elements of the procedure as 13 dissected the crura and created the fundoplication, 12 closed the crura and 11 mobilized the fundus. Residents frequently failed to complete (>25%) several essential steps including identification and protection of the anterior vagal nerve, complete dissection of the crura to the decussation and mobilization of the esophagus into the mediastinum.

Conclusions: The Delphi technique was successful in reaching expert consensus on the procedural tasks of a LNF and in creating a valid checklist. Application of this instrument demonstrated resident knowledge of major procedural steps as well as gaps about important details of the operation. By capturing automated knowledge in a checklist form, we can scaffold resident learning and close this gap. Additional psychometric testing is needed for implementation as a high stakes assessment of surgical performance.


Session: Podium Presentation

Program Number: S027

Post Views: 51

Share this:

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

Related

« Return to SAGES 2008 abstract archive

Recently, on SAGES…

Robotic Surgery

Spotlight: Robotics Committee

In the most recent issue of SCOPE, SAGES President Dr. Jeffrey Marks shared his desire to highlight the hard work of the many SAGES committees. As the Society strives to fully realize the new SAGES University Masters Program, the initial focus will be on the affiliated pathway committees and task forces. This is the third […]

Mastering the Art of Surgery – Annual Meeting Press Release

Mastering the Art of Surgery At the 16th World Congress of Endoscopic Surgery and 2018 SAGES Meeting April 11th–14th in Seattle, WA The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) will kick off its 2018 Annual Meeting as part of the 16th World Congress of Endoscopic Surgery. Hosted by SAGES and CAGS (Canadian Association […]

Complete the SAGES Video Based Assessment Survey for a Chance to Win!

https://survey.az1.qualtrics.com/jfe/form/SV_5pCM9JWvDBphkjj Who Can Enter Open to any surgeon who is either a member of SAGES or an attendee at the 2018 SAGES Annual Meeting AND who completes the 2018 SAGES Video Based Assessment Online Survey at the link above. Drawing Entry Period The drawing period is from survey launch on April 6, 2018 to 11:59pm […]

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

Newsletter Subscription

  • This field is for validation purposes and should be left unchanged.

Important Links

SAGES 2019 Meeting Information

Online Registration coming in Fall 2018

Healthy Sooner: Patient Information

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

· Log in

Copyright © 2019 Society of American Gastrointestinal and Endoscopic Surgeons · Legal
· Managed by BSC Management, Inc