Trudeau Maeve O'Neill, Nasr Ahmed, Carrillo Brian, Gerstle J Ted, Azzie Georges
Division of General Surgery, Department of Surgery, University of Toronto, Toronto, Canada,
Surg Endosc. 2015 Sep;29(9):2491-5. doi: 10.1007/s00464-014-3988-6. Epub 2014 Dec 6.
Laparoscopic models for ex vivo up-skilling are becoming increasingly important components of surgical education. This study aims to establish the construct validity and possible educational role of a new laparoscopic box trainer equipped with a motion-tracking device.
A structured questionnaire was used to assign participants into novice, intermediate, or expert categories according to level of experience in minimal access surgery (MAS). Participants carried out a well-defined intracorporeal suturing task. Three specific motion analysis parameters (MAPs)-velocity, acceleration, and range-were measured and analyzed as movements in the four degrees of freedom available in traditional MAS using tracking sensors at the trocar insertion sites.
The number of extreme velocity and acceleration events in all four degrees of freedom proved capable of differentiating between participants in the three categories of surgical experience using an ANOVA test (p < 0.001). Post hoc analysis confirmed these differences in the number of extreme velocity and acceleration events between all groups tested except for the velocity of the roll between the intermediates and experts.
These findings confirm construct validity for this new laparoscopic box trainer system, which employs a novel analysis based on motion parameters. Motion parameters provide information regarding the overall smoothness of the operator's instrument handling, an important aspect of a surgeon's technique. This preliminary data will be used to design a simulator with real-time motion feedback to enhance its educational value.
用于离体技能提升的腹腔镜模型正日益成为外科教育的重要组成部分。本研究旨在确定一种配备运动跟踪装置的新型腹腔镜训练箱的结构效度及其可能的教育作用。
使用结构化问卷根据微创外科手术(MAS)经验水平将参与者分为新手、中级或专家类别。参与者进行一项明确的体内缝合任务。使用套管针插入部位的跟踪传感器测量并分析三个特定的运动分析参数(MAPs)——速度、加速度和范围,作为传统MAS中四个自由度的运动。
使用方差分析测试(p < 0.001),所有四个自由度中的极高速和加速度事件数量能够区分三类手术经验的参与者。事后分析证实了除中级和专家之间的滚动速度外,所有测试组之间极高速和加速度事件数量的这些差异。
这些发现证实了这种新型腹腔镜训练箱系统的结构效度,该系统采用基于运动参数的新颖分析方法。运动参数提供了有关操作者器械操作整体平滑度的信息,这是外科医生技术的一个重要方面。这些初步数据将用于设计具有实时运动反馈的模拟器,以提高其教育价值。