Intracorporeal knot tying in a box trainer: how proficient is in vitro evaluation in laparoscopic experts?

To determine the applicability of motion analysis parameters of intracorporeal knot tying in box trainers in experts as predictors of surgical outcome. Consecutive series of 1534 advanced laparoscopic hysterectomies (Canadian Task Force classification II-2). Time, path length, and motion in depth of...

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Bibliographic Details
Published inJournal of minimally invasive gynecology Vol. 21; no. 2; p. 291
Main Authors Twijnstra, A R H, Hiemstra, E, van Zwet, E W, Balkema, E I R, Dankelman, J, Jansen, F W
Format Journal Article
LanguageEnglish
Published United States 01.03.2014
Subjects
Clinical Competence
Female
Humans
Hysterectomy - methods
In Vitro Techniques
Laparoscopy - methods
Operative Time
Postoperative Complications
Suture Techniques
Knot tying
Skills training
Advanced laparoscopy
Quality measures
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Summary:To determine the applicability of motion analysis parameters of intracorporeal knot tying in box trainers in experts as predictors of surgical outcome. Consecutive series of 1534 advanced laparoscopic hysterectomies (Canadian Task Force classification II-2). Time, path length, and motion in depth of a standardized intracorporeal knot-tying task were compared with mean risk-adjusted primary clinical outcomes for each participant. Although a large variety in proficient knot tying and surgical skills factors was observed; after correction for patient mix in 50 expert surgeons, motion analysis of intracorporeal knot tying could not significantly determine surgical outcome skills in advanced laparoscopic surgery. Levels of proficiency in advanced laparoscopic surgery cannot be appropriately determined using motion analysis in box trainers. Therefore, box trainer assessments do not adequately differentiate proficient from suboptimal clinical performance.
ISSN:1553-4669
DOI:10.1016/j.jmig.2013.09.008