Munenori Uemura, PhD1, Noriyuki Matsuoka2, Morimasa Tomikawa, MD, PhD1, Makoto Hashizume, MD, PhD1. 1Kyushu University, 2Kyoto Kagaku Company
INTRODUCTION: The purpose of this study was to evaluate the validity of our developed system for assessing suturing skills in laparoscopic surgery (Fig. 1). We have updated numbers of participants and a comparison method compared with the last year report.
METHODS AND PROCEDURES: Fig. 1 shows our developed computerized system for objective assessment of suturing skills by using a laparoscopic intestinal suturing model, E-Lap. The system includes a new artificial intestinal model that mimics living tissue and pressure-measuring and image-processing devices. Each examinee performs a specific skill using the artificial model, which is linked to a Suture Simulator Instruction Evaluation Unit. The model uses internal air pressure measurements and image processing to evaluate suturing skills. Five criteria, scored on a five-grade scale, were used to evaluate participants’ skills (Fig. 2). The volume of air pressure leak was determined by the volume of air inside the sutured artificial intestine. For example, for the criterion “air pressure leakage”, the approximate midpoint of the acceptable range was Grade 3. Values lower than the minimum acceptable value received lower grades and those above the midpoint of the acceptable range higher grades.
We enrolled 277 surgeons who participated a simulator competition event at the 29th annual meeting of the Japan Society for Endoscopic Surgery (JSES 2016). Participants were divided into groups: Qualified surgeon (QS; n = 58) and Non-Qualified surgeon (NQS; n = 219) groups. The Endoscopic Surgical Skill Qualification (ESSQ) System was developed in 2004 by JSES. All participants performed the skill assessment suturing task using the E-Lap and resultant scores were compared between the two groups.
RESULTS: The scores of QS and NQS for air pressure leak were 2.09 ± 1.30 and 1.68 ± 1.18, respectively; for full-thickness sutures 4.46 ± 0.73 and 4.10 ± 1.08, respectively; for suture tension 3.25 ± 1.24 and 3.27 ± 1.12, respectively; for area of wound opening 4.07 ± 1.05 and 3.24 ± 1.07, respectively; and for performance time 3.98 ± 0.97 and 3.24 ± 1.07, respectively. Significant differences (p < 0.01) between QS and NQS were observed for air pressure leak, full-thickness sutures and performance time.
CONCLUSIONS: This system could distinguish between the two groups (skillful and not skillful surgeons) from the viewpoint of the suturing surgical skill clearly and would be therefore a useful tool for training and assessment of laparoscopic surgeons.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86755
Program Number: P314
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster