Department of General, Visceral and Transplant Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstraße 1, 55131, Mainz, Germany.
Institute of Medical Biometrics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
Surg Endosc. 2018 Dec;32(12):4980-4984. doi: 10.1007/s00464-018-6260-7. Epub 2018 Jun 4.
Tools are needed to assess laparoscopic camera navigation (LCN) in the operating room. Here, we aimed to develop an objective rating scale for LCN.
We defined the following key aspects of LCN: operational field centering, correct angle of the horizon, correct instrument visualization, verbal commands from the operating surgeon, and manual corrections from the operating surgeon. We then developed a score based on intraoperative error evaluation from intraoperative recordings of 80 procedures. Finally, the newly developed score was validated by four different raters using video-based analysis of 20 elective laparoscopic cholecystectomies.
We developed and validated a tool for the structured assessment of laparoscopic assistant skills (SALAS). This score showed good internal consistency, with a Cronbach's alpha of > 0.7. Intraclass correlation revealed a low interrater variability (ICC 0.866) for the total score. Comparison of experienced and inexperienced camera assistants revealed significantly better SALAS scores for experienced assistants (p < 0.05).
Our present results show that SALAS score is valid, reliable, and practicable. This score can be used for future investigations of camera navigation efficiency and training.
需要工具来评估手术室中的腹腔镜摄像导航（LCN）。在此，我们旨在开发一种用于 LCN 的客观评分量表。
我们定义了 LCN 的以下关键方面：操作场中心定位、正确的地平线角度、正确的器械可视化、手术医生的口头指令和手术医生的手动修正。然后，我们根据 80 例手术的术中记录进行术中误差评估，制定了一个评分标准。最后，由四名不同的评估员使用 20 例择期腹腔镜胆囊切除术的视频分析对新开发的评分进行验证。
我们开发并验证了一种用于腹腔镜助手技能结构化评估的工具（SALAS）。该评分具有良好的内部一致性，Cronbach's alpha 大于 0.7。组内相关系数显示总评分的组间变异性较低（ICC 0.866）。有经验和无经验的摄像助手之间的比较显示，有经验的助手的 SALAS 评分明显更好（p<0.05）。
我们目前的结果表明，SALAS 评分是有效、可靠和可行的。该评分可用于未来对摄像导航效率和培训的研究。
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