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Robotic suturing on the FLS model possesses construct validity, is less physically demanding, and is favored by more surgeons compared with laparoscopy

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Abstract

Background

The value of robotic assistance for intracorporeal suturing is not well defined. We compared robotic suturing with laparoscopic suturing on the FLS model with a large cohort of surgeons.

Methods

Attendees (n = 117) at the SAGES 2006 Learning Center robotic station placed intracorporeal sutures on the FLS box-trainer model using conventional laparoscopic instruments and the da Vinci® robot. Participant performance was recorded using a validated objective scoring system, and a questionnaire regarding demographics, task workload, and suturing modality preference was completed. Construct validity for both tasks was assessed by comparing the performance scores of subjects with various levels of experience. A validated questionnaire was used for workload measurement.

Results

Of the participants, 84% had prior laparoscopic and 10% prior robotic suturing experience. Within the allotted time, 83% of participants completed the suturing task laparoscopically and 72% with the robot. Construct validity was demonstrated for both simulated tasks according to the participants’ advanced laparoscopic experience, laparoscopic suturing experience, and self-reported laparoscopic suturing ability (p < 0.001 for all) and according to prior robotic experience, robotic suturing experience, and self-reported robotic suturing ability (p < 0.001 for all), respectively. While participants achieved higher suturing scores with standard laparoscopy compared with the robot (84 ± 75 vs. 56 ± 63, respectively; p < 0.001), they found the laparoscopic task more physically demanding (NASA score 13 ± 5 vs. 10 ± 5, respectively; p < 0.001) and favored the robot as their method of choice for intracorporeal suturing (62 vs. 38%, respectively; p < 0.01).

Conclusions

Construct validity was demonstrated for robotic suturing on the FLS model. Suturing scores were higher using standard laparoscopy likely as a result of the participants’ greater experience with laparoscopic suturing versus robotic suturing. Robotic assistance decreases the physical demand of intracorporeal suturing compared with conventional laparoscopy and, in this study, was the preferred suturing method by most surgeons. Curricula for robotic suturing training need to be developed.

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Acknowledgments

The authors thank Chris Bell, MD, Lee Ann Lau, MD, Marc Zerey, MD, Makram Gedeon, MD, Andrew Harrell, MD, and George Walker, RN, for their help with the conduct of this study and data acquisition. We also thank Anahita Mostafavi and Amanda Walters, BS, for their help with data entry and analysis.

Disclosures

Dimitrios Stefanidis, William W. Hope, and Daniel J. Scott have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of General Surgery, Carolinas Medical Center, 1000 Blythe Blvd., MEB 601, Charlotte, NC, 28203, USA

    Dimitrios Stefanidis

  2. New Hanover Regional Medical Center, Wilmington, NC, 28401, USA

    William W. Hope

  3. University of Texas Southwestern Medical Center, Dallas, TX, 75235, USA

    Daniel J. Scott

Authors
  1. Dimitrios Stefanidis
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  2. William W. Hope
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  3. Daniel J. Scott
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Corresponding author

Correspondence to Dimitrios Stefanidis.

Appendix: Robotic suturing questionnaire

Appendix: Robotic suturing questionnaire

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Stefanidis, D., Hope, W.W. & Scott, D.J. Robotic suturing on the FLS model possesses construct validity, is less physically demanding, and is favored by more surgeons compared with laparoscopy. Surg Endosc 25, 2141–2146 (2011). https://doi.org/10.1007/s00464-010-1512-1

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  • DOI: https://doi.org/10.1007/s00464-010-1512-1

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