Skip to main content
Top
Published in: Surgical Endoscopy 8/2012

Open Access 01-08-2012

Validation of a new box trainer-related tracking device: the TrEndo

Authors: Pieter J. van Empel, Lennart B. van Rijssen, Joris P. Commandeur, Mathilde G. E. Verdam, Judith A. Huirne, Fedde Scheele, H. Jaap Bonjer, W. Jeroen Meijerink

Published in: Surgical Endoscopy | Issue 8/2012

Login to get access

Abstract

Background

There is an increasing demand for structured objective ex vivo training and assessment of laparoscopic psychomotor skills prior to implementation of these skills in practice. The aim of this study was to establish the internal validity of the TrEndo, a motion-tracking device, for implementation on a laparoscopic box trainer.

Methods

Face validity and content validity were addressed through a structured questionnaire. To assess construct validity, participants were divided into an expert group and a novice group and performed two basic laparoscopic tasks. The TrEndo recorded five motion analysis parameters (MAPs) and time.

Results

Participants demonstrated a high regard for face and content validity. All recorded MAPs differed significantly between experts and novices after performing a square knot. Overall, the TrEndo correctly assigned group membership in 84.7 and 95.7% of cases based on two laparoscopic tasks.

Conclusion

Face, content, and construct validities of the TrEndo were established. The TrEndo holds real potential as a (home) training device.
Literature
1.
go back to reference Staudacher C, Vignali A (2010) Laparoscopic surgery for rectal cancer: the state of the art. World J Gastrointest Surg 2:275–282PubMedCrossRef Staudacher C, Vignali A (2010) Laparoscopic surgery for rectal cancer: the state of the art. World J Gastrointest Surg 2:275–282PubMedCrossRef
2.
go back to reference Klarenbeek BR, Bergamaschi R, Veenhof AAFA, van der Peet DL, van den Broek WT, de Lange ESM, Bemelman WA, Heres P, Lacy AM, Cuesta MA (2011) Laparoscopic versus open sigmoid resection for diverticular disease: follow-up assessment of the randomized control Sigma trial. Surg Endosc 25:1121–1126PubMedCrossRef Klarenbeek BR, Bergamaschi R, Veenhof AAFA, van der Peet DL, van den Broek WT, de Lange ESM, Bemelman WA, Heres P, Lacy AM, Cuesta MA (2011) Laparoscopic versus open sigmoid resection for diverticular disease: follow-up assessment of the randomized control Sigma trial. Surg Endosc 25:1121–1126PubMedCrossRef
4.
go back to reference Crothers IR, Gallagher AG, McClure N, James DT, McGuigan J (1999) Experienced laparoscopic surgeons are automated to the “fulcrum effect”: an ergonomic demonstration. Endoscopy 31:365–369PubMedCrossRef Crothers IR, Gallagher AG, McClure N, James DT, McGuigan J (1999) Experienced laparoscopic surgeons are automated to the “fulcrum effect”: an ergonomic demonstration. Endoscopy 31:365–369PubMedCrossRef
5.
go back to reference Gallagher AG, McClure N, McGuigan J, Ritchie K, Sheehy NP (1998) An ergonomic analysis of the fulcrum effect in the acquisition of endoscopic skills. Endoscopy 30:617–620PubMedCrossRef Gallagher AG, McClure N, McGuigan J, Ritchie K, Sheehy NP (1998) An ergonomic analysis of the fulcrum effect in the acquisition of endoscopic skills. Endoscopy 30:617–620PubMedCrossRef
6.
go back to reference Hanna GB, Cuschieri A (1999) Influence of the optical axis-to-target view angle on endoscopic task performance. Surg Endosc 13:371–375PubMedCrossRef Hanna GB, Cuschieri A (1999) Influence of the optical axis-to-target view angle on endoscopic task performance. Surg Endosc 13:371–375PubMedCrossRef
7.
go back to reference Tholey G, Desai JP, Castellanos AE (2005) Force feedback plays a significant role in minimally invasive surgery: results and analysis. Ann Surg 241:102–109PubMed Tholey G, Desai JP, Castellanos AE (2005) Force feedback plays a significant role in minimally invasive surgery: results and analysis. Ann Surg 241:102–109PubMed
8.
go back to reference Westebring-van der Putten EP, Goossens RHM, Jakimowicz JJ, Dankelman J (2008) Haptics in minimally invasive surgery—a review. Minim Invasive Ther Allied Technol 17:3–16PubMedCrossRef Westebring-van der Putten EP, Goossens RHM, Jakimowicz JJ, Dankelman J (2008) Haptics in minimally invasive surgery—a review. Minim Invasive Ther Allied Technol 17:3–16PubMedCrossRef
9.
go back to reference Bais JE, Bartelsman JF, Bonjer HJ, Cuesta MA, Go PM, Klinkenberg-Knol EC, van Lanschot JJ, Nadorp JH, Smout AJ, van der Graaf Y, Gooszen HG (2000) Laparoscopic or conventional Nissen fundoplication for gastro-oesophageal reflux disease: randomised clinical trial. The Netherlands Antireflux Surgery Study Group. Lancet 355:170–174PubMedCrossRef Bais JE, Bartelsman JF, Bonjer HJ, Cuesta MA, Go PM, Klinkenberg-Knol EC, van Lanschot JJ, Nadorp JH, Smout AJ, van der Graaf Y, Gooszen HG (2000) Laparoscopic or conventional Nissen fundoplication for gastro-oesophageal reflux disease: randomised clinical trial. The Netherlands Antireflux Surgery Study Group. Lancet 355:170–174PubMedCrossRef
10.
go back to reference Gouma DJ, Go PM (1994) Bile duct injury during laparoscopic and conventional cholecystectomy. J Am Coll Surg 178:229–233PubMed Gouma DJ, Go PM (1994) Bile duct injury during laparoscopic and conventional cholecystectomy. J Am Coll Surg 178:229–233PubMed
11.
go back to reference Moore MJ, Bennett CL (1995) The learning curve for laparoscopic cholecystectomy. The Southern Surgeons Club. Am J Surg 170:55–59PubMedCrossRef Moore MJ, Bennett CL (1995) The learning curve for laparoscopic cholecystectomy. The Southern Surgeons Club. Am J Surg 170:55–59PubMedCrossRef
12.
go back to reference Sariego J, Spitzer L, Matsumoto T (1993) The “learning curve” in the performance of laparoscopic cholecystectomy. Int Surg 78:1–3PubMed Sariego J, Spitzer L, Matsumoto T (1993) The “learning curve” in the performance of laparoscopic cholecystectomy. Int Surg 78:1–3PubMed
13.
go back to reference Kauvar DS, Braswell A, Brown BD, Harnisch M (2006) Influence of resident and attending surgeon seniority on operative performance in laparoscopic cholecystectomy. J Surg Res 132:159–163PubMedCrossRef Kauvar DS, Braswell A, Brown BD, Harnisch M (2006) Influence of resident and attending surgeon seniority on operative performance in laparoscopic cholecystectomy. J Surg Res 132:159–163PubMedCrossRef
14.
go back to reference Bridges M, Diamond DL (1999) The financial impact of teaching surgical residents in the operating room. Am J Surg 177:28–32PubMedCrossRef Bridges M, Diamond DL (1999) The financial impact of teaching surgical residents in the operating room. Am J Surg 177:28–32PubMedCrossRef
15.
go back to reference Fried GM, Feldman LS, Vassiliou MC, Fraser SA, Stanbridge D, Ghitulescu G, Andrew CG (2004) Proving the value of simulation in laparoscopic surgery. Ann Surg 240:518–525PubMedCrossRef Fried GM, Feldman LS, Vassiliou MC, Fraser SA, Stanbridge D, Ghitulescu G, Andrew CG (2004) Proving the value of simulation in laparoscopic surgery. Ann Surg 240:518–525PubMedCrossRef
16.
go back to reference Scott DJ, Bergen PC, Rege RV, Laycock R, Tesfay ST, Valentine RJ, Euhus DM, Jeyarajah DR, Thompson WM, Jones DB (2000) Laparoscopic training on bench models: Better and more cost effective than operating room experience? J Am Coll Surg 191:272–283PubMedCrossRef Scott DJ, Bergen PC, Rege RV, Laycock R, Tesfay ST, Valentine RJ, Euhus DM, Jeyarajah DR, Thompson WM, Jones DB (2000) Laparoscopic training on bench models: Better and more cost effective than operating room experience? J Am Coll Surg 191:272–283PubMedCrossRef
17.
go back to reference Grantcharov TP, Kristiansen VB, Bendix J, Bardram L, Rosenberg J, Funch-Jensen P (2004) Randomized clinical trial of virtual reality simulation for laparoscopic skills training. Br J Surg 91:146–150PubMedCrossRef Grantcharov TP, Kristiansen VB, Bendix J, Bardram L, Rosenberg J, Funch-Jensen P (2004) Randomized clinical trial of virtual reality simulation for laparoscopic skills training. Br J Surg 91:146–150PubMedCrossRef
18.
go back to reference Korndorffer JRJ, Dunne JB, Sierra R, Stefanidis D, Touchard CL, Scott DJ (2005) Simulator training for laparoscopic suturing using performance goals translates to the operating room. J Am Coll Surg 201:23–29PubMedCrossRef Korndorffer JRJ, Dunne JB, Sierra R, Stefanidis D, Touchard CL, Scott DJ (2005) Simulator training for laparoscopic suturing using performance goals translates to the operating room. J Am Coll Surg 201:23–29PubMedCrossRef
19.
go back to reference Seymour NE, Gallagher AG, Roman SA, O’Brien MK, Bansal VK, Andersen DK, Satava RM (2002) Virtual reality training improves operating room performance: results of a randomized, double-blinded study. Ann Surg 236:458–463PubMedCrossRef Seymour NE, Gallagher AG, Roman SA, O’Brien MK, Bansal VK, Andersen DK, Satava RM (2002) Virtual reality training improves operating room performance: results of a randomized, double-blinded study. Ann Surg 236:458–463PubMedCrossRef
20.
go back to reference Aggarwal R, Ward J, Balasundaram I, Sains P, Athanasiou T, Darzi A (2007) Proving the effectiveness of virtual reality simulation for training in laparoscopic surgery. Ann Surg 246:771–779PubMedCrossRef Aggarwal R, Ward J, Balasundaram I, Sains P, Athanasiou T, Darzi A (2007) Proving the effectiveness of virtual reality simulation for training in laparoscopic surgery. Ann Surg 246:771–779PubMedCrossRef
21.
go back to reference Botden SM, Jakimowicz JJ (2009) What is going on in augmented reality simulation in laparoscopic surgery? Surg Endosc 23:1693–1700PubMedCrossRef Botden SM, Jakimowicz JJ (2009) What is going on in augmented reality simulation in laparoscopic surgery? Surg Endosc 23:1693–1700PubMedCrossRef
22.
go back to reference Darzi A, Smith S, Taffinder N (1999) Assessing operative skill. Needs to become more objective. BMJ 318:887–888PubMedCrossRef Darzi A, Smith S, Taffinder N (1999) Assessing operative skill. Needs to become more objective. BMJ 318:887–888PubMedCrossRef
23.
go back to reference Martin JA, Regehr G, Reznick R, MacRae H, Murnaghan J, Hutchison C, Brown M (1997) Objective structured assessment of technical skill (OSATS) for surgical residents. Br J Surg 84:273–278PubMedCrossRef Martin JA, Regehr G, Reznick R, MacRae H, Murnaghan J, Hutchison C, Brown M (1997) Objective structured assessment of technical skill (OSATS) for surgical residents. Br J Surg 84:273–278PubMedCrossRef
24.
go back to reference Moorthy K, Munz Y, Sarker SK, Darzi A (2003) Objective assessment of technical skills in surgery. BMJ 327:1032–1037PubMedCrossRef Moorthy K, Munz Y, Sarker SK, Darzi A (2003) Objective assessment of technical skills in surgery. BMJ 327:1032–1037PubMedCrossRef
25.
go back to reference Anastakis DJ, Regehr G, Reznick RK, Cusimano M, Murnaghan J, Brown M, Hutchison C (1999) Assessment of technical skills transfer from the bench training model to the human model. Am J Surg 177:167–170PubMedCrossRef Anastakis DJ, Regehr G, Reznick RK, Cusimano M, Murnaghan J, Brown M, Hutchison C (1999) Assessment of technical skills transfer from the bench training model to the human model. Am J Surg 177:167–170PubMedCrossRef
26.
go back to reference Grober ED, Hamstra SJ, Wanzel KR, Reznick RK, Matsumoto ED, Sidhu RS, Jarvi KA (2004) The educational impact of bench model fidelity on the acquisition of technical skill: the use of clinically relevant outcome measures. Ann Surg 240:374–381PubMedCrossRef Grober ED, Hamstra SJ, Wanzel KR, Reznick RK, Matsumoto ED, Sidhu RS, Jarvi KA (2004) The educational impact of bench model fidelity on the acquisition of technical skill: the use of clinically relevant outcome measures. Ann Surg 240:374–381PubMedCrossRef
27.
go back to reference Dhariwal AK, Prabhu RY, Dalvi AN, Supe AN (2007) Effectiveness of box trainers in laparoscopic training. J Minim Access Surg 3:57–63PubMedCrossRef Dhariwal AK, Prabhu RY, Dalvi AN, Supe AN (2007) Effectiveness of box trainers in laparoscopic training. J Minim Access Surg 3:57–63PubMedCrossRef
28.
go back to reference Munz Y, Kumar BD, Moorthy K, Bann S, Darzi A (2004) Laparoscopic virtual reality and box trainers: Is one superior to the other? Surg Endosc 18:485–494PubMedCrossRef Munz Y, Kumar BD, Moorthy K, Bann S, Darzi A (2004) Laparoscopic virtual reality and box trainers: Is one superior to the other? Surg Endosc 18:485–494PubMedCrossRef
29.
go back to reference Derossis AM, Fried GM, Abrahamowicz M, Sigman HH, Barkun JS, Meakins JL (1998) Development of a model for training and evaluation of laparoscopic skills. Am J Surg 175:482–487PubMedCrossRef Derossis AM, Fried GM, Abrahamowicz M, Sigman HH, Barkun JS, Meakins JL (1998) Development of a model for training and evaluation of laparoscopic skills. Am J Surg 175:482–487PubMedCrossRef
31.
go back to reference Gallagher AG, Ritter EM, Satava RM (2003) Fundamental principles of validation, and reliability: rigorous science for the assessment of surgical education and training. Surg Endosc 17:1525–1529PubMedCrossRef Gallagher AG, Ritter EM, Satava RM (2003) Fundamental principles of validation, and reliability: rigorous science for the assessment of surgical education and training. Surg Endosc 17:1525–1529PubMedCrossRef
32.
go back to reference Aggarwal R, Moorthy K, Darzi A (2004) Laparoscopic skills training and assessment. Br J Surg 91:1549–1558PubMedCrossRef Aggarwal R, Moorthy K, Darzi A (2004) Laparoscopic skills training and assessment. Br J Surg 91:1549–1558PubMedCrossRef
33.
go back to reference Schijven M, Jakimowicz J (2003) Construct validity: experts and novices performing on the Xitact LS500 laparoscopy simulator. Surg Endosc 17:803–810PubMedCrossRef Schijven M, Jakimowicz J (2003) Construct validity: experts and novices performing on the Xitact LS500 laparoscopy simulator. Surg Endosc 17:803–810PubMedCrossRef
34.
go back to reference Gallagher AG, Lederman AB, McGlade K, Satava RM, Smith CD (2004) Discriminative validity of the minimally invasive surgical trainer in virtual reality (MIST-VR) using criteria levels based on expert performance. Surg Endosc 18:660–665PubMedCrossRef Gallagher AG, Lederman AB, McGlade K, Satava RM, Smith CD (2004) Discriminative validity of the minimally invasive surgical trainer in virtual reality (MIST-VR) using criteria levels based on expert performance. Surg Endosc 18:660–665PubMedCrossRef
35.
go back to reference Duffy AJ, Hogle NJ, McCarthy H, Lew JI, Egan A, Christos P, Fowler DL (2005) Construct validity for the LAPSIM laparoscopic surgical simulator. Surg Endosc 19:401–405PubMedCrossRef Duffy AJ, Hogle NJ, McCarthy H, Lew JI, Egan A, Christos P, Fowler DL (2005) Construct validity for the LAPSIM laparoscopic surgical simulator. Surg Endosc 19:401–405PubMedCrossRef
37.
go back to reference Chmarra MK, Grimbergen CA, Dankelman J (2007) Systems for tracking minimally invasive surgical instruments. Minim Invasive Ther Allied Technol 16:328–340PubMedCrossRef Chmarra MK, Grimbergen CA, Dankelman J (2007) Systems for tracking minimally invasive surgical instruments. Minim Invasive Ther Allied Technol 16:328–340PubMedCrossRef
38.
go back to reference Chmarra MK, Klein S, de Winter JCF, Jansen FW, Dankelman J (2010) Objective classification of residents based on their psychomotor laparoscopic skills. Surg Endosc 24:1031–1039PubMedCrossRef Chmarra MK, Klein S, de Winter JCF, Jansen FW, Dankelman J (2010) Objective classification of residents based on their psychomotor laparoscopic skills. Surg Endosc 24:1031–1039PubMedCrossRef
39.
go back to reference MacFadyen BVJ (2004) Teaching, training, and clinical surgery: Are we making a difference? Surg Endosc 18:361–362PubMedCrossRef MacFadyen BVJ (2004) Teaching, training, and clinical surgery: Are we making a difference? Surg Endosc 18:361–362PubMedCrossRef
40.
go back to reference Dunkin B, Adrales GL, Apelgren K, Mellinger JD (2007) Surgical simulation: a current review. Surg Endosc 21:357–366PubMedCrossRef Dunkin B, Adrales GL, Apelgren K, Mellinger JD (2007) Surgical simulation: a current review. Surg Endosc 21:357–366PubMedCrossRef
41.
go back to reference Pearson AM, Gallagher AG, Rosser JC, Satava RM (2002) Evaluation of structured and quantitative training methods for teaching intracorporeal knot tying. Surg Endosc 16:130–137PubMedCrossRef Pearson AM, Gallagher AG, Rosser JC, Satava RM (2002) Evaluation of structured and quantitative training methods for teaching intracorporeal knot tying. Surg Endosc 16:130–137PubMedCrossRef
42.
go back to reference Van Sickle KR, McClusky DA, Gallagher AG, Smith CD (2005) Construct validation of the ProMIS simulator using a novel laparoscopic suturing task. Surg Endosc 19:1227–1231PubMedCrossRef Van Sickle KR, McClusky DA, Gallagher AG, Smith CD (2005) Construct validation of the ProMIS simulator using a novel laparoscopic suturing task. Surg Endosc 19:1227–1231PubMedCrossRef
43.
go back to reference Botden SM, Berlage JT, Schijven MP, Jakimowicz JJ (2008) Face validity study of the ProMIS augmented reality laparoscopic suturing simulator. Surg Technol Int 17:26–32PubMed Botden SM, Berlage JT, Schijven MP, Jakimowicz JJ (2008) Face validity study of the ProMIS augmented reality laparoscopic suturing simulator. Surg Technol Int 17:26–32PubMed
44.
go back to reference Gunther S, Rosen J, Hannaford B, Sinanan M (2007) The red DRAGON: a multi-modality system for simulation and training in minimally invasive surgery. Stud Health Technol Inform 125:149–154PubMed Gunther S, Rosen J, Hannaford B, Sinanan M (2007) The red DRAGON: a multi-modality system for simulation and training in minimally invasive surgery. Stud Health Technol Inform 125:149–154PubMed
45.
go back to reference Korndorffer JRJ, Kasten SJ, Downing SM (2010) A call for the utilization of consensus standards in the surgical education literature. Am J Surg 199:99–104PubMedCrossRef Korndorffer JRJ, Kasten SJ, Downing SM (2010) A call for the utilization of consensus standards in the surgical education literature. Am J Surg 199:99–104PubMedCrossRef
46.
go back to reference Basdogan C, De S, Kim J, Muniyandi M, Kim H, Srinivasan MA (2004) Haptics in minimally invasive surgical simulation and training. IEEE Comput Graph Appl 24:56–64PubMedCrossRef Basdogan C, De S, Kim J, Muniyandi M, Kim H, Srinivasan MA (2004) Haptics in minimally invasive surgical simulation and training. IEEE Comput Graph Appl 24:56–64PubMedCrossRef
47.
go back to reference Strom P, Hedman L, Sarna L, Kjellin A, Wredmark T, Fellander-Tsai L (2006) Early exposure to haptic feedback enhances performance in surgical simulator training: a prospective randomized crossover study in surgical residents. Surg Endosc 20:1383–1388PubMedCrossRef Strom P, Hedman L, Sarna L, Kjellin A, Wredmark T, Fellander-Tsai L (2006) Early exposure to haptic feedback enhances performance in surgical simulator training: a prospective randomized crossover study in surgical residents. Surg Endosc 20:1383–1388PubMedCrossRef
48.
go back to reference Botden SM, Torab F, Buzink SN, Jakimowicz JJ (2008) The importance of haptic feedback in laparoscopic suturing training and the additive value of virtual reality simulation. Surg Endosc 22:1214–1222PubMedCrossRef Botden SM, Torab F, Buzink SN, Jakimowicz JJ (2008) The importance of haptic feedback in laparoscopic suturing training and the additive value of virtual reality simulation. Surg Endosc 22:1214–1222PubMedCrossRef
49.
go back to reference Scott DJ, Dunnington GL (2008) The new ACS/APDS skills curriculum: moving the learning curve out of the operating room. J Gastrointest Surg 12:213–221PubMedCrossRef Scott DJ, Dunnington GL (2008) The new ACS/APDS skills curriculum: moving the learning curve out of the operating room. J Gastrointest Surg 12:213–221PubMedCrossRef
50.
go back to reference Yamaguchi S, Yoshida D, Kenmotsu H, Yasunaga T, Konishi K, Ieiri S, Nakashima H, Tanoue K, Hashizume M (2011) Objective assessment of laparoscopic suturing skills using a motion-tracking system. Surg Endosc 25:771–775PubMedCrossRef Yamaguchi S, Yoshida D, Kenmotsu H, Yasunaga T, Konishi K, Ieiri S, Nakashima H, Tanoue K, Hashizume M (2011) Objective assessment of laparoscopic suturing skills using a motion-tracking system. Surg Endosc 25:771–775PubMedCrossRef
51.
go back to reference Smith SG, Torkington J, Brown TJ, Taffinder NJ, Darzi A (2002) Motion analysis. Surg Endosc 16:640–645PubMedCrossRef Smith SG, Torkington J, Brown TJ, Taffinder NJ, Darzi A (2002) Motion analysis. Surg Endosc 16:640–645PubMedCrossRef
52.
go back to reference Wetzel CM, Kneebone RL, Woloshynowych M, Nestel D, Moorthy K, Kidd J, Darzi A (2006) The effects of stress on surgical performance. Am J Surg 191:5–10PubMedCrossRef Wetzel CM, Kneebone RL, Woloshynowych M, Nestel D, Moorthy K, Kidd J, Darzi A (2006) The effects of stress on surgical performance. Am J Surg 191:5–10PubMedCrossRef
53.
go back to reference 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 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
Metadata
Title
Validation of a new box trainer-related tracking device: the TrEndo
Authors
Pieter J. van Empel
Lennart B. van Rijssen
Joris P. Commandeur
Mathilde G. E. Verdam
Judith A. Huirne
Fedde Scheele
H. Jaap Bonjer
W. Jeroen Meijerink
Publication date
01-08-2012
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 8/2012
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-012-2187-6

Other articles of this Issue 8/2012

Surgical Endoscopy 8/2012 Go to the issue