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Procedural surgical skill assessment in laparoscopic training environments

  • Munenori UemuraEmail author
  • Pierre Jannin
  • Makoto Yamashita
  • Morimasa Tomikawa
  • Tomohiko Akahoshi
  • Satoshi Obata
  • Ryota Souzaki
  • Satoshi Ieiri
  • Makoto Hashizume
Original Article

Abstract

Purpose

This study aimed to identify detailed differences in laparoscopic surgical processes between expert and novice surgeons in a training environment and demonstrate that surgical process modeling can be used for such detailed analysis.

Methods

Eleven expert surgeons each of whom had performed \({>}500\) laparoscopic procedures were compared with 10 young surgeons each of whom had performed \({<}15\) laparoscopic procedures, and five medical students. Each examinee performed a specific skill assessment task. During tasks, instrument motion was monitored using a video capture system. From the video, the corresponding workflow was recorded by labeling the surgeons’ activities according to a predefined terminology. Activities represented manual work steps performed during the task, described by a combination of a verb (representing the action), a tool, and the involved structure. The results were described as the number of occurrences (times), average duration (seconds), total duration (seconds), minimal duration (seconds), maximal duration (seconds), and occupancy percentage (%).

Results

The terminology for describing the processes of this task included 10 actions, six tools, four structures, and three events for each hand. There were 63 combinations of different possible activities; significant differences in 12 activities were observed between the expert and novice groups (young surgeons and medical students). The expert group performed the task with fewer occurrences and shorter duration than did the novice group in the left hand.

Conclusions

We identified differences in surgical process between experts and novices in laparoscopic surgical simulation. Our proposed method would be useful for education and training in laparoscopic surgery.

Keywords

Surgical skills Laparoscopic surgery Surgical training Surgical process model 

Notes

Acknowledgments

This work was supported by The Ministry of Education, Culture, Sports, Science, and Technology and Japan Society for the Promotion of Science KAKENHI Grant Nos. 26108010, 26870428, Joint Research Projects of Bilateral Programs with JSPS’s Counterpart Institutions and by French Ministry of Foreign and European Affairs and the Ministry of education and research and EGIDE/Sakura grant.

Compliance with ethical standards

Conflict of interest

Drs. Uemura, Jannin, Yamashita, Tomikawa, Akahoshi, Obata, Souzaki, Ieiri, and Hashizume declare that they have no conflicts of interest.

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Copyright information

© CARS 2015

Authors and Affiliations

  • Munenori Uemura
    • 1
    Email author
  • Pierre Jannin
    • 2
    • 3
  • Makoto Yamashita
    • 1
  • Morimasa Tomikawa
    • 4
  • Tomohiko Akahoshi
    • 1
  • Satoshi Obata
    • 4
  • Ryota Souzaki
    • 4
  • Satoshi Ieiri
    • 4
  • Makoto Hashizume
    • 1
    • 4
  1. 1.Department of Advanced Medical Initiatives, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  2. 2.INSERM, U1099RennesFrance
  3. 3.LTSIUniversité de Rennes 1RennesFrance
  4. 4.Department of Advanced Medicine and Innovative TechnologyKyushu University HospitalFukuokaJapan

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