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

SAGES

Reimagining surgical care for a healthier world

  • Home
    • 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
    • SAGES Store
    • 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
    • “Unofficial” Logo Products
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2024 Scientific Session Call For Abstracts
      • 2024 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • 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
    • Fellows Career Development Course
    • 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
    • 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
  • OWLS
  • Log In

Operating in the Comfort Zone: Interns Perform Better with Straight over Articulating Instruments

Bethany R Lowndes, Bernadette McCrory, PhD, Chad A LaGrange, MD, David R Farley, MD, Raaj K Ruparel, MD, Yazan N AlJamal, MBBS, Susan Hallbeck, PhD. Mayo Clinic, University of Nebraska Medical Center, University of Nebraska – Lincoln.

Introduction: Laparoendoscopic Single-Site surgery (LESS) is a surgical technique performed using a single, small incision typically within the patient’s umbilicus. LESS presents several technical challenges for the surgeon compared to conventional laparoscopy: a single incision causes intra- and extra-corporeal collisions, limits the ability to triangulate instruments, and the view of instruments is inline and transposed (i.e., the surgeon’s right instrument operates on the left side). As an emerging technique surgeons have relied upon conventional laparoscopic instrumentation, which were not designed specifically for LESS. To enable surgeons to perform LESS more efficiently, effectively and most importantly safely, research must identify and eventually enhance the performance abilities of such instruments for surgeons. As an initial step toward technique and instrumentation optimization, the aim of this study was to objectively compare the technical performance and usability of three different instruments (one straight and two articulating) within a LESS training simulator.
 

Methods and Procedures: Twelve surgical interns volunteered to perform the Fundamentals of Laparoscopic Surgery (FLS) peg transfer task in a specially designed single-port trainer (Brown-Clerk et al., 2011). Each participant donned surgical gloves, completed a 5 minute hands-on familiarization period and then performed the peg transfer within the validated LESS box trainer (Brown-Clerk et al., 2011), using pairs of ENDOPATH Dissectors (Ethicon Endo-Surgery, Inc., Cincinnati, Ohio), SILS Dissectors (Covidien, Mansfield, Massachusetts) and Autonomy Laparo-Angle Maryland Dissectors (CambridgeEndo, Framingham, Massachusetts) in a random order.
 

Results: The mean time to complete the FLS peg transfer task was significantly less using the pair of straight tools (ANOVA, p=0.005). Participants performed comparably using all instruments with respect to errors. Although there were more total recoverable errors (i.e., dropped pegs that were picked up and successfully transferred) than non-recoverable, the total number of errors did not differ across instruments.
 

FLS Time and Errors by Laparoscopic Instrument Type
INSTRUMENT TIME (sec) Errors (counts)  
  Mean Std Dev Recoverable Non-recoverable Total
Cambridge 239 67.3 8 0 8
Covidien 223 46.3 6 3 9
Straight 163 22.7 6 2 8

Discussion: Even with a similar number of total errors, trainees performed significantly faster when using standard straight laparoscopic instruments in the LESS environment. This study suggests that articulating tools may not be intuitively understood bysurgical interns. Given the inherent complexity of articulating instrumentation, further work to characterize the learning curves of surgical trainees for LESS is needed to better understand the true potential of the instrumentation and understand the training needed in order to attain and maintain proficiency.

View Poster

86

Share this:

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

Related

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064
1-310-437-0544
[email protected]
Monday - Friday
8am to 5pm Pacific Time

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