Skip to main content

Advertisement

SpringerLink
Log in

Analysis of the quality and efficiency in learning laparoscopic skills

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Objectives

This study demonstrates the application of time-action analysis to the evaluation of task performance of diagnostic laparoscopy with laparoscopic ultrasonography.

Methods

The first 25 diagnostic laparoscopies with laparoscopic ultrasonography performed by a surgical resident were analyzed and compared with the outcomes of these procedures performed by an experienced surgeon. The time, actions, and correctness of task performance were evaluated. Furthermore, outcome correctness and postoperative complications were assessed.

Results

No postoperative complications occurred. The resident made one wrong diagnosis, for which the cause was detected by peroperative analysis. Additionally, 1% of the subtasks were performed only partially, 4% not at all, and 2% using the wrong technique. The efficiency for most diagnostic tasks remained significantly lower than that of the experienced surgeon (p<0.001).

Conclusions

Time-action analysis can be used to provide detailed insight into the quality and efficiency of learning surgical skills. It enables objective measurement of correctness in task performance as well as time and action efficiency.

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

Similar content being viewed by others

References

  1. Barnes RM (1980) Motion and time study: design and measurement of work. John Wiley & Sons, New York, pp

    Google Scholar 

  2. Bessell JR, Baxter P, Riddell P, Watkin S, Maddern GJ (1996) A randomized controlled trial of laparoscopic extraperitoneal hernia repair as a day surgical procedure. Surg Endosc 10: 495–500

    Article  CAS  PubMed  Google Scholar 

  3. Boer den KT, Wit de LT, Gouma DJ, Dankelman J (1999) Perioperative time-motion analysis of diagnostic laparoscopy with laparoscopic ultrasonography. Br J Surg 86: 951–955

    Article  Google Scholar 

  4. Chew FS, Smirniotopoulos JG (1993) Educational efficacy of computer-assisted instruction with interactive videodisc in radiology. Invest Radiol 28: 1052–1058

    Article  CAS  PubMed  Google Scholar 

  5. Claus GP, Sjoerdsma W, Jansen A, Grimbergen CA (1995) Quantitative standardised analysis of advanced laparoscopic surgical procedures. Endosc Surg Allied Technol 3: 210–213

    CAS  PubMed  Google Scholar 

  6. Cuschieri A, Wilson RG, Sunderland G, McIntyre IM, Youngson GG, Cash JD, Mackay N, Shields SR (1997) Training initiative list scheme (TILS) for minimal access therapy: the MATTUS experience. J R Coll Surg Edinb 42: 295–302

    CAS  PubMed  Google Scholar 

  7. Delden van OM, Wit de LT, Nieveen van Dijkum EJM, Smits NJ, Gouma DJ, Reeders JWAJ (1997) Value of laparoscopic ultrasonography in staging of proximal bile duct tumors. J Ultrasound Med 17: 7–12

    Google Scholar 

  8. Deschamps C, Allen MS, Trastek VF, Johnson JO, Pairolero PC (1998) Early experience and learning curve associated with laparoscopic Nissen fundoplication. J Thorac Cardiovasc Surg 115: 281–284

    Article  CAS  PubMed  Google Scholar 

  9. Gordon TA, Bowman HM, Tielsch JM, Bass EB, Burleyson GP, Cameron JL (1998) Statewide regionalization of pancreaticoduodenectomy and its effect on in-hospital mortality. Ann Surg 228: 71–78

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  10. Gouma DJ, de Wit LT, Nieveen van Dijkum EJM, VanDelden OM, Bemelman WA, Rauws EAJ, VanLanschot JJB, Obertop H (1996) Laparoscopic ultrasonography for staging of gastrointestinal malignancy. Scand J Gastroenterology 218: 43–49

    Article  CAS  Google Scholar 

  11. Leval de MR (1997) Human factors and surgical outcomes: a Cartesian dream. Lancet 349: 723–725

    Article  PubMed  Google Scholar 

  12. Lieberman MD, Kilburn H, Lindsey MBMF (1995) Relation of perioperative deaths to hospital volume among patients undergoing pancreatic resection for malignancy. Ann Surg 222: 638–645

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  13. Nieveen van Dijkum EJM, DeWit LT, VanDelden OM, Rauws EAJ, VanLanshot JJB, Obertop H, Gouma DJ (1997) The efficacy of laparoscopic stating in patients with upper gastrointestinal tumors. Cancer 79: 1315–1319

    Article  CAS  PubMed  Google Scholar 

  14. Rosser JC, Rosser LE, Savalgi RS (1997) Skill acquisition and assessment for laparoscopic surgery. Arch Surg 132: 200–204

    Article  CAS  PubMed  Google Scholar 

  15. Shapiro SJ, Paz-Partlow M, Daykhovsky L, Gordon LA (1996) The use of a modular skills center for the maintenance of laparoscopic skills. Surg Endosc 10: 816–819

    Article  CAS  PubMed  Google Scholar 

  16. Society of American Endoscopic Surgeons (SAGES) Integrating advanced laparoscopy into surgical residency training. Surg Endosc 12: 374–376

  17. Traverso LW, Koo KP, Hargrave K (1997) Standardizing laparoscopic procedure time and determining the effect of patient age/gender and presence or absence of surgical residents during operation: a prospective multicenter trial. Surg Endosc 11: 226–229

    Article  CAS  PubMed  Google Scholar 

  18. Wickens CD (1992) Memory, learning, and training. In: Pearson L, Caterer MC (eds) Engineering psychology and human performance. HarperCollins, New York, pp 211–257

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Faculty of Design, Engineering and Production, Man-Machine Systems Group, Delft University of Technology, Mekelweg 2, 2628 CD, Delft, The Netherlands

    K. T. den Boer & J. Dankelman

  2. Department of Surgery, Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE, Amsterdam, The Netherlands

    K. T. den Boer, L. Th. de Wit, P. H. P. Davids & D. J. Gouma

Authors
  1. K. T. den Boer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. L. Th. de Wit
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P. H. P. Davids
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Dankelman
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. D. J. Gouma
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Online publication: 3 April 2001

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

den Boer, K.T., de Wit, L.T., Davids, P.H.P. et al. Analysis of the quality and efficiency in learning laparoscopic skills. Surg Endosc 15, 497–503 (2001). https://doi.org/10.1007/s004640090002

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s004640090002

Key words

Search

Navigation