Skip to main content

Advertisement

SpringerLink
Log in

New models for advanced laparoscopic suturing: taking it to the next level

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Current simulations for laparoscopic suturing do not reflect the complexity of the skills required in the operating room. The purpose of this study was to develop three novel advanced suturing tasks with assessment metrics and to collect validity evidence for their measures of suturing skill.

Methods

We developed three tasks based on training gaps identified through a previous needs assessment: needle handling (NH), suturing under tension (UT), and continuous suturing (CS). Minimally invasive surgeons (MIS) and senior surgical residents (SR) completed these tasks and a questionnaire regarding their educational value. Performance was assessed by two raters based on time and accuracy. Validity was assessed by comparing performance according to the level of training and self-reported experience. The inter-rater reliability and internal consistency of the tasks were calculated.

Results

Thirty-one subjects (13 MIS, 18 SR) were enrolled in the study (median age 32; 77 % male). Compared to the SR group, the MIS group had significantly greater scores on all tasks. While all MIS surgeons completed the three tasks within the allotted time, six (33 %) residents could not complete at least one out of the three tasks. Laparoscopic suturing experience correlated positively with the scores of all tasks (NH 0.51, UT 0.70, CS 0.65. p < 0.01). Inter-rater reliability for all tasks was 0.99, and internal consistency was 0.80. The majority of participants agreed that the tasks were relevant to practice, helped improve technical competence, and adequately measured suturing ability.

Conclusions

This study provides validity evidence for three novel advanced laparoscopic suturing tasks. Performance on all tasks correlated significantly with training level and self-reported experience. Integrating these tasks into educational curricula may help improve residents’ suturing skills and better prepare residents for the operating room.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Fried GM, Feldman LS, Vassiliou MC, Fraser SA, Stanbridge D, Ghitulescu G, Andrew CG (2004) Proving the value of simulation in laparoscopic surgery. Ann Surg 240:518–528

    Article  PubMed Central  PubMed  Google Scholar 

  2. McCluney AL, Vassiliou MC, Kaneva PA, Cao J, Stanbridge DD, Feldman LS, Fried GM (2007) FLS simulator performance predicts intraoperative laparoscopic skill. Surg Endosc. doi:10.1007/s00464-007-9451-1

    PubMed  Google Scholar 

  3. Sroka G, Feldman LS, Vassiliou MC, Kaneva PA, Fayez R, Fried GM (2010) Fundamentals of laparoscopic surgery simulator training to proficiency improves laparoscopic performance in the operating room-a randomized controlled trial. Am J Surg 199:115–120

    Article  PubMed  Google Scholar 

  4. Mattar SG, Alseidi AA, Jones DB, Jeyarajah DR, Swanström LL, Aye RW, Wexner SD, Martinez JM, Ross SB, Awad MM, Franklin ME, Arregui ME, Schirmer BD, Minter RM (2013) General surgery residency inadequately prepares trainees for fellowship: results of a Survey of Fellowship Program Directors. Ann Surg 258:440–449

    Article  PubMed  Google Scholar 

  5. Dehabadi M, Fernando B, Berlingieri P (2014) The use of simulation in the acquisition of laparoscopic suturing skills. Int J Surg 12:258–268

    Article  PubMed  Google Scholar 

  6. Moorthy K, Munz Y, Dosis A, Bello F, Chang A, Darzi A (2004) Bimodal assessment of laparoscopic suturing skills: construct and concurrent validity. Surg Endosc. doi:10.1007/s00464-003-9312-5

    Google Scholar 

  7. Aggarwal R, Boza C, Hance J, Leong J, Lacy A, Darzi A (2007) Skills acquisition for laparoscopic gastric bypass in the training laboratory: an innovative approach. Obes Surg 17:19–27

    Article  PubMed  Google Scholar 

  8. Downing SM (2003) Validity: on meaningful interpretation of assessment data. Med Educ 37:830–837

    Article  PubMed  Google Scholar 

  9. The American Educational Research Association, American Psychological Association, and the National Council on Measurement in Education (2014) Standard for Educational and Psychological Testing. American Educational Research Association, Washington

  10. Nepomnayshy D, Whitledge J, Birkett R, Delmonico T, Ruthazer R, Sillin L, Seymour NE (2014) Evaluation of advanced laparoscopic skills tasks for validity evidence. Surg Endosc. doi:10.1007/s00464-014-3674-8

    Google Scholar 

  11. Watanabe Y, Matt Ritter E, Schwaitzberg SD, Korndorffer JR, Scott DJ, Okrainec A, Bilgic E, Kaneva PA, O’Donnell MT, Feldman LS, Fried GM, Vassiliou MC (2014) Camera navigation and cannulation: validity evidence for new educational tasks to complement the Fundamentals of Laparoscopic Surgery Program. Surg Endosc. doi:10.1007/s00464-014-3721-5

    Google Scholar 

  12. Fried GM, Derossis AM, Bothwell J, Sigman HH (1999) Comparison of laparoscopic performance in vivo with performance measured in a laparoscopic simulator. Surg Endosc 13:1077–1082

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The authors would like to acknowledge Dr. Carmen Mueller, Pepa A. Kaneva, and Petru Niculiseanu for their unrelenting support. Without the generosity of all of the participants, this study and this program would not have been possible.

Conflict of interest

Drs. Yusuke Watanabe, Katherine M. McKendy, Ghada Enani, Amin Madani, Amani Munshi, and Elif Bilgic have no conflicts of interest or financial ties to disclose. The Steinberg-Bernstein Centre receives an unrestricted educational grant from Covidien. Dr. Liane Feldman received an unrestricted educational grant from ConMed.

Author information

Authors and Affiliations

  1. Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, 1650 Cedar Avenue, D6-136, Montreal, QC, H3G 1A4, Canada

    Yusuke Watanabe, Katherine M. McKendy, Elif Bilgic, Ghada Enani, Amin Madani, Amani Munshi, Liane S. Feldman, Gerald M. Fried & Melina C. Vassiliou

Authors
  1. Yusuke Watanabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Katherine M. McKendy
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Elif Bilgic
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ghada Enani
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Amin Madani
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Amani Munshi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Liane S. Feldman
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Gerald M. Fried
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Melina C. Vassiliou
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yusuke Watanabe.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Watanabe, Y., McKendy, K.M., Bilgic, E. et al. New models for advanced laparoscopic suturing: taking it to the next level. Surg Endosc 30, 581–587 (2016). https://doi.org/10.1007/s00464-015-4242-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-015-4242-6

Keywords

Search

Navigation