Sarker Sudip K, Chang Avril, Vincent Charles, Darzi Sir Ara W
Clinical Safety Research Unit, Department of Surgical Oncology and Technology, South Wharf Rd., 10th Floor QEQM Bldg., St Mary's Hospital, London, UK.
Am J Surg. 2006 Feb;191(2):238-44. doi: 10.1016/j.amjsurg.2005.07.031.
Assessing live laparoscopic surgery using structured methodology is still in its infancy; however, it removes bias and subjectivity. We critique a new assessment tool for technical skills in laparoscopic surgery.
A hierarchical task analysis was done for laparoscopic cholecystectomy (LC), and a global assessment for generic and specific technical skills for LC was developed. Two experienced surgeons with >12 years of postgraduate experience assessed 50 full-length LC operations blindly and independently.
Five consultant/attending and 4 registrar/resident surgeons were recruited. Interrater reliability was k = 0.86 and k = 0.84 (P < .05) for generic and specific technical skills, respectively. Mean time for consultants was 32 minutes (range 15 to 70) and for registrars was 53 minutes (range 20 to 90). Parametric Student t test analysis was significant for time between the 2 groups, P < .05. Nonparametric analysis of variance between the 2 groups for generic and specific technical skills was significant at P < .05.
This assessment tool for live laparoscopic surgery may have face, content, concurrent, construct, and predictive validities for generic and specific technical skills. We aim to continue the study and expand assessment to other surgical techniques.
使用结构化方法评估实时腹腔镜手术仍处于起步阶段；然而，它消除了偏见和主观性。我们对一种新的腹腔镜手术技术技能评估工具进行了批判。
对腹腔镜胆囊切除术（LC）进行了层次任务分析，并开发了针对LC的通用和特定技术技能的整体评估。两名具有超过12年研究生经验的经验丰富的外科医生对50例完整的LC手术进行了盲法独立评估。
招募了5名顾问/主治医生和4名住院医生/住院医师。通用和特定技术技能的评分者间信度分别为k = 0.86和k = 0.84（P <.05）。顾问医生的平均手术时间为32分钟（范围15至70分钟），住院医生为53分钟（范围20至90分钟）。两组之间手术时间的参数学生t检验分析具有显著性，P <.05。两组之间通用和特定技术技能的非参数方差分析在P <.05时具有显著性。
这种实时腹腔镜手术评估工具对于通用和特定技术技能可能具有表面效度、内容效度、同时效度、结构效度和预测效度。我们旨在继续这项研究，并将评估扩展到其他手术技术。
