Department of Surgery, Regional Hospital West Jutland, Herning, Denmark.
Aarhus University, Aarhus, Denmark.
Surg Endosc. 2022 Mar;36(3):1761-1774. doi: 10.1007/s00464-021-08914-z. Epub 2021 Dec 6.
In laparoscopic colorectal surgery, higher technical skills have been associated with improved patient outcome. With the growing interest in laparoscopic techniques, pressure on surgeons and certifying bodies is mounting to ensure that operative procedures are performed safely and efficiently. The aim of the present review was to comprehensively identify tools for skill assessment in laparoscopic colon surgery and to assess their validity as reported in the literature.
A systematic search was conducted in EMBASE and PubMed/MEDLINE in May 2021 to identify studies examining technical skills assessment tools in laparoscopic colon surgery. Available information on validity evidence (content, response process, internal structure, relation to other variables, and consequences) was evaluated for all included tools.
Fourteen assessment tools were identified, of which most were procedure-specific and video-based. Most tools reported moderate validity evidence. Commonly not reported were rater training, assessment correlation with variables other than training level, and validity reproducibility and reliability in external educational settings.
The results of this review show that several tools are available for evaluation of laparoscopic colon cancer surgery, but few authors present substantial validity for tool development and use. As we move towards the implementation of new techniques in laparoscopic colon surgery, it is imperative to establish validity before surgical skill assessment tools can be applied to new procedures and settings. Therefore, future studies ought to examine different aspects of tool validity, especially correlation with other variables, such as patient morbidity and pathological reports, which impact patient survival.
在腹腔镜结直肠手术中，较高的技术水平与改善患者预后相关。随着对腹腔镜技术兴趣的增加，对外科医生和认证机构的压力也越来越大，以确保手术操作的安全和高效。本综述的目的是全面确定腹腔镜结肠手术中技能评估的工具，并评估其在文献中的有效性。
2021 年 5 月，在 EMBASE 和 PubMed/MEDLINE 中进行了系统检索，以确定研究腹腔镜结肠手术中技术技能评估工具的研究。对所有纳入的工具，评估了有效性证据（内容、反应过程、内部结构、与其他变量的关系和后果）的可用信息。
确定了 14 种评估工具，其中大多数是特定于程序的和基于视频的。大多数工具报告了中等有效性证据。通常未报告的是评估者的培训、评估与培训水平以外的变量的相关性，以及在外部教育环境中的有效性可重复性和可靠性。
本综述的结果表明，有几种工具可用于评估腹腔镜结肠癌手术，但很少有作者提出实质性的工具开发和使用有效性。随着新的腹腔镜结肠手术技术的实施，在手术技能评估工具能够应用于新的程序和环境之前，必须先建立有效性。因此，未来的研究应该检查工具有效性的不同方面，特别是与其他变量（如患者发病率和病理报告）的相关性，这些变量会影响患者的生存。
