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01-11-2020 | New Technology

Construct validity of the SurgForce system for objective assessment of laparoscopic suturing skills

Authors: Salvador Montoya-Alvarez, Arturo Minor-Martínez, Ricardo Manuel Ordorica-Flores, Luis Padilla-Sánchez, Jesús Tapia-Jurado, Fernando Pérez-Escamirosa

Published in: Surgical Endoscopy | Issue 11/2020

Abstract

Background

Laparoscopic surgery requires a new set of skill to be learned by the surgeons, of which the most relevant is tissue manipulation. Excessive forces applied to the tissue can cause rupture during manipulation or ischemia when confronting both sides of the tissue. The aim of this study is to establish the construct validity of the SurgForce system for objective assessment of advanced laparoscopic skills, based on the force signal generated during suture tasks, and the development of force parameters for evaluating tissue handling interaction.

Methods

The SurgForce system, a tissue handling training device that measures dynamic force, was used to capture the force generated by surgeons with different levels of laparoscopic experience. For construct validity, 37 participants were enrolled in this study: 19 medical students, 12 residents of surgical specialties and 6 expert surgeons. All participants performed an intracorporeal knotting suture task over a synthetic tissue pad with a laparoscopic box-trainer. The force performance of the participants was analyzed using 11 force-based parameters with the application of the SurgForce system. Statistical analysis was performed between novice, intermediate, and expert groups using a Kruskal–Wallis test, and between the pairs of groups using a Mann–Whitney U–test.

Results

Overall, 9 of the 11 force-related parameters showed significant differences between the three study groups. Results between the pairs of groups presented significant differences in 5 force parameters proposed. Construct validity results demonstrated that the SurgForce system was able to differentiate force performance between surgeons with different levels of laparoscopic experience.

Conclusion

The SurgForce system was successfully validated. This force system showed its potential to measure the force exerted on tissue for objective assessment of tissue handling skills in suturing tasks. Furthermore, its compact design allows the use of this device in conventional laparoscopic box-trainers.

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Title: Construct validity of the SurgForce system for objective assessment of laparoscopic suturing skills
Authors: Salvador Montoya-Alvarez
Arturo Minor-Martínez
Ricardo Manuel Ordorica-Flores
Luis Padilla-Sánchez
Jesús Tapia-Jurado
Fernando Pérez-Escamirosa
Publication date: 01-11-2020
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 11/2020
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-020-07873-1

At a glance: The STEP trials

Springer Medicine

Construct validity of the SurgForce system for objective assessment of laparoscopic suturing skills

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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