Surgical Endoscopy

, Volume 28, Issue 3, pp 918–924

Design and validation of an assessment tool for open surgical procedures

  • Neil Rittenhouse
  • Bharat Sharma
  • Ranil Sonnadara
  • Alex Mihailidis
  • Teodor Grantcharov
Article

DOI: 10.1007/s00464-013-3247-2

Cite this article as:
Rittenhouse, N., Sharma, B., Sonnadara, R. et al. Surg Endosc (2014) 28: 918. doi:10.1007/s00464-013-3247-2

Abstract

Background

Laparoscopy is currently the gold standard for cholecystectomy. Recent literature suggests surgical trainees have limited exposure to open cholecystectomy, which may result in suboptimal performance in the event of conversion. Furthermore, most training and assessment models are designed for laparoscopic cholecystectomy, with limited opportunities for open simulator training. The present study’s purpose was to design an inexpensive model for open cholecystectomy and to validate a performance assessment tool.

Methods

The simulator comprises a porcine liver and gallbladder in a mock human abdomen with silicon skin. The assessment tool utilizes inexpensive infrared (IR) cameras to provide tracking of participant hand motions. Eleven novice general surgery trainees (<20 cholecystectomies) and five expert surgeons (>100 cholecystectomies) completed an open cholecystectomy using the simulator. Procedures were recorded and assessed by a blinded evaluator using a global rating scale. Tracking data analysis was based on number of movements and total path length.

Results

Novices (t = 36.18 min) completed the procedure significantly slower than did experts (t = 19.53 min) (Mann–Whitney test U = 20, p < 0.05) and had significantly more hand movements (Mann–Whitney test U = 20, p < 0.05). Analysis of the total global rating scale scores showed a significant difference between novice (14/35) and expert (24/35) performance in all categories (Mann–Whitney test U = 58, p < 0.05).

Conclusion

The present model presents a realistic, low-cost tool for training and assessment of procedural skills in open cholecystectomy. The study demonstrated the validity of the IR tracking device as an objective assessment tool for open surgical skills training. Future training should incorporate this low-cost, highly effective training device into surgical curricula.

Keywords

Education Cholecystectomy Simulation Technical 

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Neil Rittenhouse
    • 1
    • 3
  • Bharat Sharma
    • 2
    • 3
  • Ranil Sonnadara
    • 2
    • 4
  • Alex Mihailidis
    • 1
    • 5
    • 6
  • Teodor Grantcharov
    • 2
    • 3
  1. 1.Institute of Biomaterials and Biomedical EngineeringUniversity of TorontoTorontoCanada
  2. 2.Department of SurgeryUniversity of TorontoTorontoCanada
  3. 3.Division of General Surgery CC16St. Michael’s HospitalTorontoCanada
  4. 4.Mount Sinai HospitalTorontoCanada
  5. 5.Department of Occupational Science & Occupational TherapyUniversity of TorontoTorontoCanada
  6. 6.Toronto Rehabilitation InstituteTorontoCanada

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