Abstract
Background
An accurate and objective measuring tool is lacking for laparoscopic suture accuracy assessment in simulation training. We designed and developed the suture accuracy testing system (SATS) and aimed to determine its construct validity in this study.
Methods
Twenty laparoscopic experts and 20 novices were recruited to perform a suturing task in three sessions using traditional laparoscopic instruments (Tra. session), a handheld multi-degree-of-freedom (MDoF) laparoscopic instrument (MDoF session) and a surgical robot (Rob. session), respectively. The needle entry and exit errors were calculated using the SATS and compared between the two groups.
Results
No significant difference of the needle entry error was found in all comparisons. As for the needle exit error, the value of the novice group was significantly higher than that of the expert group in Tra. session (3.48 ± 0.61 mm vs. 0.85 ± 0.14 mm; p = 1.451e-11) and MDoF session (2.65 ± 0.41 mm vs. 1.06 ± 0.17 mm; p = 1.451e-11) but not in Rob. session (0.51 ± 0.12 mm vs. 0.45 ± 0.08 mm; p = 0.091).
Conclusions
The SATS demonstrates construct validity. Surgeons’ experience in conventional laparoscopic instruments could be transferred to the MDoF instrument. Surgical robot helps to improve suture accuracy and may bridge the experience gap between laparoscopic experts and novices in basic exercises.
Similar content being viewed by others
References
Athanasiadis DI, Anton NE, Karim A et al (2021) Does the advanced training in laparoscopic suturing enhance laparoscopic suturing skill beyond fundamentals of laparoscopic surgery? Surgery 170:1125–1130
Bilgic E, Alyafi M, Hada T et al (2019) Simulation platforms to assess laparoscopic suturing skills: a scoping review. Surg Endosc 33:2742–2762
Westwood E, Malla B, Ward J et al (2020) The impact of a laparoscopic surgery training course in a developing country. World J Surg 44:3284–3289
Chandra V, Nehra D, Parent R et al (2010) A comparison of laparoscopic and robotic assisted suturing performance by experts and novices. Surgery 147:830–839
Feng J, Yang K, Zhang Z et al (2020) Handheld laparoscopic robotized instrument: progress or challenge? Surg Endosc 34:719–727
Bilgic E, Endo S, Lebedeva E et al (2018) A scoping review of assessment tools for laparoscopic suturing. Surg Endosc 32:3009–3023
IJgosse WM, Leijte E, Ganni S et al (2020) Competency assessment tool for laparoscopic suturing: development and reliability evaluation. Surg Endosc 34(2947):2953
Nepomnayshy D, Alseidi AA, Fitzgibbons SC et al (2016) Identifying the need for and content of an advanced laparoscopic skills curriculum: results of a national survey. Am J Surg 211:421–425
Abboudi H, Khan MS, Aboumarzouk O et al (2013) Current status of validation for robotic surgery simulators-a systematic review. BJU Int 111:194–205
Feng J, Yan Z, Li M et al (2021) Handheld robotic needle holder training: slower but better. Surg Endosc 35:1667–1674
Bilgic E, Takao M, Kaneva P et al (2018) Development of a model for the acquisition and assessment of advanced laparoscopic suturing skills using an automated device. Surg Innov 25:286–290
Park YS, Oo AM, Son SY et al (2016) Is a robotic system really better than the three-dimensional laparoscopic system in terms of suturing performance?: comparison among operators with different levels of experience. Surg Endosc 30:1485–1490
Våpenstad C, FagertunHofstad E, Eivind Bernstein T et al (2020) Optimal timing of assessment tasks depending on experience level of surgical trainees. Minim Invasive Ther Allied Technol 29:161–169
Kowalewski KF, Schmidt MW, Proctor T et al (2018) Skills in minimally invasive and open surgery show limited transferability to robotic surgery: results from a prospective study. Surg Endosc 32:1656–1667
Pimentel M, Cabral RD, Costa MM et al (2018) Does previous laparoscopic experience influence basic robotic surgical skills? J Surg Educ 75:1075–1081
Singh H, Modi HN, Ranjan S et al (2018) Robotic surgery improves technical performance and enhances prefrontal activation during high temporal demand. Ann Biomed Eng 46:1621–1636
Acknowledgements
We would like to thank all the volunteers in this study for their kind and strong support.
Funding
This study was funded by the Youth Talent Project of the Health Commission of Hubei Province (Grant No. WJ2019Q050) and the Science, Technology and Innovation Seed Fund of Zhongnan Hospital of Wuhan University (Grant No. znpy2019003). The grants are not relevant to the submitted work.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical approval
No institutional review board approval was needed since the study did not involve human trials.
Informed consent
Informed consent was obtained from all individual participants included in the study.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Below is the link to the electronic supplementary material.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Xu, S., Chen, Y., Luo, N. et al. Construct Validity of a Novel Assessment System for Laparoscopic Suture Accuracy Based on Stereoscopy. World J Surg 47, 1358–1363 (2023). https://doi.org/10.1007/s00268-023-06940-7
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00268-023-06940-7