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Surgical Endoscopy

Published in:

01-12-2006

Quantification of process measures in laparoscopic suturing

Authors: A. Dubrowski, J. C. Larmer, J. K. Leming, R. Brydges, H. Carnahan, J. Park

Published in: Surgical Endoscopy | Issue 12/2006

Abstract

Background

Process measures describing the generation of movement are useful for evaluation and performance feedback purposes. This study aimed to identify process measures that differ between novice and advanced laparoscopists while completing a suturing skill.

Methods

A group of junior and a group of senior residents and fellows in surgery (n = 6) placed 10 laparoscopic sutures in a synthetic model. Process measures were quantified using an opto-electric motion/force sensor assembly that recorded: instrument rotation, applied forces, time, and time delays between force application and instrument rotation.

Results

Advanced trainees showed increased instrument rotation, higher peak applied force, and faster performance compared to novices (all p < .01). However, over trials, only novices showed adaptations for instrument rotation and total time (interactions at p < .01) with no adaptation for the force application. The difference between the moments of force application and instrument rotation was not sensitive to participant training.

Conclusions

Movement process measures can enhance our understanding of early adaptation processes and how such factors might be used as feedback to facilitate skill acquisition.

Aggarwal R, Hance J, Darzi A (2004) Surgical education and training in the new millennium. Surg Endosc 18: 1409–1410PubMedCrossRef

Aggarwal R, Moorthy K, Darzi A (2004) Laparoscopic skills training and assessment. Br J Surg 91: 1549–1558PubMedCrossRef

Datta V, Chang A, Mackay S, Darzi A (2002) The relationship between motion analysis and surgical technical assessments. Am J Surg 184: 70–73PubMedCrossRef

Datta V, Mackay S, Mandalia M, Darzi A (2001) The use of electromagnetic motion tracking analysis to objectively measure open surgical skill in the laboratory-based model. J Am Coll Surg 193: 479–485PubMedCrossRef

Dubrowski A, Sidhu R, Park J, Carnahan H (2005) Quantification of motion characteristics and forces applied to tissues during suturing. Am J Surg 190: 131–136PubMedCrossRef

Fitts PM, Posner MI (1967) Human performance. Belmont CA, Books: Cole Publishing

Gallagher AG, Satava RM (2002) Virtual reality as a metric for the assessment of laparoscopic psychomotor skills. Learning curves and reliability measures. Surg Endosc 16: 1746–1752PubMedCrossRef

Gentile AM (1972) A working model of skill acquisition with application to teaching. Quest, Monograph 17: 3–23

Gentile AM (2000) Skill acquisition: action, movement, and neuromotor processes. In Carr JH, Shepherd RB (eds), Movement Science: Foundations for Physical Therapy, Rockville, MD, Aspen Publishing, 111–187

10.

Hore J, Watts S, Tweed D (1996) Errors in the control of joint rotations associated with inaccuracies in overarm throws. J Neurophysiol 75: 1013–1025PubMed

11.

Hore J, Watts S, Tweed D, Miller B (1996) Overarm throws with the nondominant arm: kinematics of accuracy. J Neurophysiol 76: 3693–3704PubMed

12.

Latash ML, Gelfand IM, Li Z-M, Zatsiorsky VM (1998) Changes in the force-sharing pattern induced by modifications of visual feedback during force production by a set of fingers. Exp Brain Res 123: 255–262PubMedCrossRef

13.

Perkins N, Starkes JL, Lee TD, Hutchison C (2002) Learning to use minimal access surgical instruments and 2-dimensional remote visual feedback: how difficult is the task for novices? Adv Health Sci Educ 7: 117–131CrossRef

14.

Rosser JC, Rosser LE, Savalgi RS (1997) Skill acquisition and assessment for laparoscopic surgery. Arch Surg 132: 200–204PubMed

15.

Schmidt RA, Lee TD. (2005) Motor Control and Learning: A Behavioral Emphasis. Champaign, IL, Human Kinetics

16.

Scott DJ, Valentine RJ, Bergen PC, Rege RV, Laycock R, Tesfay ST, Jones DB (2000) Evaluating surgical competency with the American Board of Surgery In-Training Examination, skill testing, and intraoperative assessment. Surgery 128: 613–622PubMedCrossRef

17.

Guadagnoli MA, Lee TD (2004) Challenge point: a framework for conceptualizing the effects of various practice conditions in motor learning. J Mot Behav 36: 212–224PubMed

Title: Quantification of process measures in laparoscopic suturing
Authors: A. Dubrowski
J. C. Larmer
J. K. Leming
R. Brydges
H. Carnahan
J. Park
Publication date: 01-12-2006
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 12/2006
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-005-0759-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Quantification of process measures in laparoscopic suturing

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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