Tiong Ho Yee, So Wei Zheng, Yuen-Chun Teoh Jeremy, Isotani Shuji, Zhu Gang, Ong Teng Aik, Shu-Yin Chan Eddie, Sau-Kwan Chu Peggy, Kijvikai Kittinut, Liu Ming, Lojanapiwat Bannakji, Wong Michael, Chi-Fai Ng Anthony
Yong Loo Lin School of Medicine, Department of Surgery, National University of Singapore, Singapore.
Department of Urology, National University Hospital, Singapore.
Asian J Urol. 2024 Jul;11(3):443-449. doi: 10.1016/j.ajur.2022.12.002. Epub 2023 Jan 11.
To correlate the utility of the Fundamentals of Laparoscopic Surgery (FLS) manual skills program with the Objective Structured Assessment of Technical Skills (OSATS) global rating scale in evaluating operative performance.
The Asian Urological Surgery Training and Educational Group (AUSTEG) Laparoscopic Upper Tract Surgery Course implemented and validated the FLS program for its usage in laparoscopic surgical training. Delegates' basic laparoscopic skills were assessed using three different training models (peg transfer, precision cutting, and intra-corporeal suturing). They also performed live porcine laparoscopic surgery at the same workshop. Live surgery skills were assessed by blinded faculty using the OSATS rating scale.
From March 2016 to March 2019, a total of 81 certified urologists participated in the course, with a median of 5 years of post-residency experience. Although differences in task time did not reach statistical significance, those with more surgical experience were visibly faster at completing the peg transfer and intra-corporeal suturing FLS tasks. However, they took longer to complete the precision cutting task than participants with less experience. Overall OSATS scores correlated weakly with all three FLS tasks (peg transfer time: =-0.331, =0.110; precision cutting time: =-0.240, =0.058; suturing with intra-corporeal knot time: =-0.451, =0.203).
FLS task parameters did not correlate strongly with OSATS globing rating scale performance. Although FLS task models demonstrated strong validity, it is important to assimilate the inconsistencies when benchmarking technical proficiency against real-life operative competence, as evaluated by FLS and OSATS, respectively.
在评估手术操作表现时，将腹腔镜手术基础（FLS）手动技能程序的效用与客观结构化技术技能评估（OSATS）整体评分量表进行关联。
亚洲泌尿外科手术培训与教育小组（AUSTEG）腹腔镜上尿路手术课程实施并验证了FLS程序在腹腔镜手术培训中的应用。使用三种不同的训练模型（移钉、精确切割和体内缝合）评估学员的基本腹腔镜技能。他们还在同一研讨会上进行了猪的活体腹腔镜手术。由不知情的教员使用OSATS评分量表评估活体手术技能。
2016年3月至2019年3月，共有81名获得认证的泌尿外科医生参加了该课程，他们住院后平均有5年工作经验。虽然任务时间的差异未达到统计学意义，但手术经验更丰富的医生在完成移钉和体内缝合FLS任务时明显更快。然而，他们完成精确切割任务的时间比经验较少的参与者更长。总体OSATS评分与所有三项FLS任务的相关性较弱（移钉时间：=-0.331，=0.110；精确切割时间：=-0.240，=0.058；体内打结缝合时间：=-0.451，=0.203）。
FLS任务参数与OSATS整体评分量表表现的相关性不强。虽然FLS任务模型显示出很强的有效性，但在分别通过FLS和OSATS评估将技术熟练程度与实际手术能力进行对标时，必须考虑到这些不一致之处。
