Nervil G G, Medici R, Thomsen J L D, Staehr-Rye A K, Asadzadeh S, Rosenberg J, Gätke M R, Madsen M V
Department of Anesthesiology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark.
Department of Surgery, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
Acta Anaesthesiol Scand. 2017 Nov;61(10):1270-1277. doi: 10.1111/aas.13001.
Recently, studies have focused on how to optimize laparoscopic surgical workspace by changes in intra-abdominal pressure, level of muscle relaxation or body position, typically evaluated by surgeons using subjective rating scales. We aimed to validate two rating scales by having surgeons assess surgical workspace in video sequences recorded during laparoscopic surgery.
Video sequences were obtained from laparoscopic procedures. Eight experienced surgeons assessed the video sequences on a categorical 5-point scale and a numerical 10-point rating scale. Intraclass correlations coefficients (ICC) and 95% confidence intervals (CI) were calculated for intra- and inter-rater reliability.
The 5-point rating scale had an intra-rater ICC of 0.76 (0.69; 0.83) and an inter-rater ICC of 0.57 (0.45; 0.68), corresponding to excellent and fair reliability, respectively. The 10-point scale had an intra-rater ICC of 0.86 (0.82; 0.89) and an inter-rater ICC of 0.54 (0.39; 0.68), corresponding to excellent and fair as well. All surgeons used the full range of the 5-point scale, but only one surgeon used the full range of the 10-point scale.
In conclusion, both scales showed excellent intra-rater and fair inter-rater reliability for assessing surgical workspace in laparoscopy. The 5-point surgical rating scale had all categories employed by all surgeons.
最近，研究聚焦于如何通过改变腹内压、肌肉松弛程度或体位来优化腹腔镜手术操作空间，通常由外科医生使用主观评分量表进行评估。我们旨在通过让外科医生评估腹腔镜手术过程中录制的视频序列中的手术操作空间，来验证两种评分量表。
从腹腔镜手术中获取视频序列。八位经验丰富的外科医生以5分分类量表和10分数字量表对视频序列进行评估。计算评分者内和评分者间可靠性的组内相关系数（ICC）和95%置信区间（CI）。
5分量表的评分者内ICC为0.76（0.69；0.83），评分者间ICC为0.57（0.45；0.68），分别对应优秀和中等可靠性。10分量表的评分者内ICC为0.86（0.82；0.89），评分者间ICC为0.54（0.39；0.68），也分别对应优秀和中等。所有外科医生都使用了5分量表的全部分类，但只有一位外科医生使用了10分量表的全部分类。
总之，两种量表在评估腹腔镜手术操作空间时均显示出优秀的评分者内和中等的评分者间可靠性。5分手术评分量表的所有分类都被所有外科医生使用。
