Herbert Geraint L, Cundy Thomas P, Singh Pritam, Retrosi Giuseppe, Sodergren Mikael H, Azzie Georges, Darzi Ara
The Hamlyn Centre, Institute of Global Health Innovation, Imperial College London, UK.
The Hamlyn Centre, Institute of Global Health Innovation, Imperial College London, UK.
J Pediatr Surg. 2015 Oct;50(10):1762-6. doi: 10.1016/j.jpedsurg.2015.03.057. Epub 2015 Apr 15.
This study aims to adapt an existing multiport pediatric laparoscopic surgery simulator to be suitable for pediatric single-port laparoscopy and to investigate construct validity for its use as a resource for skills training and assessment.
An existing pediatric-sized box trainer was modified to accommodate a commercially available port. A total of 41 participants (18 novices, 16 intermediates and 7 experts) were recruited to complete four curriculum tasks via a single-port access approach. Objective task performance scores were evaluated.
Task completion times and performance scores were significantly different between novices and experts for the peg transfer (P = 0.02, P = 0.008 respectively), pattern cut (P < 0.001, P < 0.001 respectively) and ligating loop (P = 0.038, P = 0.035 respectively). There were significant differences in outcomes between novices and intermediates for all tasks, including the intracorporeal suture task (P ≤ 0.001). There were no significant differences in outcomes between intermediates and experts for all tasks.
The Pediatric Laparoscopic Surgery (PLS) simulator can be easily adapted for single-port laparoscopic surgery to be construct valid for the peg transfer, ligating loop and pattern cut tasks. There is scope for additional tasks to be developed that focus on the unique technical challenges and skills associated with single-port techniques.
本研究旨在对现有的多端口小儿腹腔镜手术模拟器进行改造，使其适用于小儿单孔腹腔镜手术，并探讨其作为技能培训和评估资源的结构效度。
对现有的小儿尺寸的箱式训练器进行改造，以容纳一个市售端口。共招募了41名参与者（18名新手、16名中级人员和7名专家），通过单孔入路完成四项课程任务。评估客观任务表现得分。
在新手和专家之间，对于套圈转移（分别为P = 0.02，P = 0.008）、图案切割（分别为P < 0.001，P < 0.001）和结扎环（分别为P = 0.038，P = 0.035）任务，任务完成时间和表现得分存在显著差异。在所有任务中，包括体内缝合任务，新手和中级人员之间的结果存在显著差异（P≤0.001）。在所有任务中，中级人员和专家之间的结果没有显著差异。
小儿腹腔镜手术（PLS）模拟器可以很容易地改造为适用于单孔腹腔镜手术，对于套圈转移、结扎环和图案切割任务具有结构效度。有必要开发更多侧重于单孔技术独特技术挑战和技能的任务。
