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Surgical Endoscopy
Published in: Surgical Endoscopy 8/2016

01-08-2016 | New Technology

Training model for laparoscopic Heller and Dor fundoplication: a tool for laparoscopic skills training and assessment—construct validity using the GOALS score

Authors: Omar Bellorin, Anna Kundel, Saurabh Sharma, Alexander Ramirez-Valderrama, Paul Lee

Published in: Surgical Endoscopy | Issue 8/2016

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Abstract

Background

Laparoscopic training demands practice. The transfer of laparoscopic skills from training models to real surgical procedures has been proven. The global operative assessment of laparoscopic skills (GOALS) score is a 5-item global rating scale developed to evaluate laparoscopic skills by direct observation. This scale has been used to demonstrate construct validity of several laparoscopic training models. Here, we present a low-cost model of laparoscopic Heller–Dor for advanced laparoscopic training. The aim of this study was to determine the capability of a training model for laparoscopic Heller–Dor to discriminate between different levels of laparoscopic expertise.

Methods

The performance of two groups with different levels of expertise, novices (<30 laparoscopic procedures PGY1-2) and experts (>300 laparoscopic procedures PGY4-5) was assessed. All participants were instructed to perform two tasks (esophageal myotomy and fundoplication). All the performances were recorded in a digital format. A laparoscopic expert who was blinded to subject’s identity evaluated the recordings using the GOALS score. Autonomy, one of the five items of GOALS, was removed since the evaluator and the trainee did not have interaction. The time required to finish each task was also recorded. Performance was compared using the Mann–Whitney U test (p < 0.05 was significant).

Results

Twenty subjects were evaluated: ten in each group, using the GOALS score. The mean total GOALS score for novices was 7.5 points (SD: 1.64) and 13.9 points (SD: 1.66) for experts (p < 0.05).The expert group was superior in each domain of the GOALS score compared to novices: depth perception (mean: 3.3 vs 2 p < 0.05), bimanual dexterity (mean 3.4 vs 2.1 p < 0.05), efficiency (mean 3.4 vs 1.7 p < 0.05) and tissue handling (mean 3.6 vs 1.7 p < 0.05). With regard to time, experts were superior in task 1 (mean 9.7 vs 14.9 min p < 0.05) and task 2 (mean 24 vs 47.1 min p < 0.05) compared to novices.

Conclusions

The laparoscopic Heller–Dor training model has construct validity. The model may be used as a tool for training of the surgical resident.
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Metadata
Title
Training model for laparoscopic Heller and Dor fundoplication: a tool for laparoscopic skills training and assessment—construct validity using the GOALS score
Authors
Omar Bellorin
Anna Kundel
Saurabh Sharma
Alexander Ramirez-Valderrama
Paul Lee
Publication date
01-08-2016
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 8/2016
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-015-4617-8

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