Rodriguez Omaira, Sanchez-Ismayel Alexis, Sanchez Renata, Pena Romina, Salamo Oriana
Robotic and minimally invasive surgery center (CIMI). La Floresta medical Institute. Caracas, Venezuela, Central University of Venezuela; Surgery Department III, University Hospital of Caracas, Caracas, Venezuela; Avenida Principal de Santa Sofía, Torre Alfa, Piso 9, Consultório 9C, Santa Sofía, El Cafetal, Caracas, Miranda 1061, Venezuela.
JSLS. 2013 Jul-Sep;17(3):445-9. doi: 10.4293/108680813X13654754534710.
The use of training models in laparoscopic surgery allows the surgical team to practice procedures in a safe environment. The aim of this study was to determine the capability of an inanimate laparoscopic appendectomy model to discriminate between different levels of surgical experience (construct validity).
The performance of 3 groups with different levels of expertise in laparoscopic surgery--experts (Group A), intermediates (Group B), and novices (Group C)--was evaluated. The groups were instructed of the task to perform in the model using a video tutorial. Procedures were recorded in a digital format for later analysis using the Global Operative Assessment of Laparoscopic Skills (GOALS) score; procedure time was registered. The data were analyzed using the analysis of variance test.
Twelve subjects were evaluated, 4 in each group, using the GOALS score and time required to finish the task. Higher scores were observed in the expert group, followed by the intermediate and novice groups, with statistically significant difference. Regarding procedure time, a significant difference was also found between the groups, with the experts having the shorter time. The proposed model is able to discriminate among individuals with different levels of expertise, indicating that the abilities that the model evaluates are relevant in the surgeon's performance.
Construct validity for the inanimate full-task laparoscopic appendectomy training model was demonstrated. Therefore, it is a useful tool in the development and evaluation of the resident in training.
在腹腔镜手术中使用训练模型可使手术团队在安全环境中练习手术操作。本研究的目的是确定无生命的腹腔镜阑尾切除术模型区分不同手术经验水平的能力（结构效度）。
评估了腹腔镜手术专业水平不同的三组人员——专家（A组）、中级人员（B组）和新手（C组）。通过视频教程指导各组人员在模型中执行任务。手术过程以数字格式记录，以便日后使用腹腔镜手术技能全球评估（GOALS）评分进行分析；记录手术时间。使用方差分析对数据进行分析。
对12名受试者进行了评估，每组4人，采用GOALS评分和完成任务所需时间。专家组得分更高，其次是中级组和新手组，差异具有统计学意义。关于手术时间，各组之间也存在显著差异，专家组用时更短。所提出的模型能够区分不同专业水平的个体，表明该模型评估的能力与外科医生的表现相关。
证明了无生命的全任务腹腔镜阑尾切除术训练模型的结构效度。因此，它是培训住院医师的有用工具。
