Page 42 - WJOLS - Journal of Laparoscopic Surgery

WJOLS

Systematic Review of Laparoscopic Surgery and Simulation-based Training

(Cont’d…)

Table 3: Published reference, context of final assessment, source of assessment, skills assessed posttraining, and results from studies

Results from research studies Trained group performed significantly better on time (p = 0.038), total path length (p = 0.001), total number of movements (p = 0.009), and overall rating scores (p = 0.001) Trained group demonstrated dexterity scores equivalent to expert levels The performance with MIST-VR correlated with surgery skills. MIST-VR did not improve surgical skills. MIST-VR did predict surgical outcomes Intervention group made signific

Skills assessed posttraining Change in operative performance: (1) Time taken; (2) total path length; (3) total number of movements The OSATS global rating scale Exposure errors, clipping and tissue division errors, and dissection errors Performance was broken up into phases: (1) Exposure of the cystic duct and artery; (2) clip placement followed by division of the cystic duct and artery; (3) gallbladder excision: Total time, path length, angul

Source of final assessment ratings Two observers (OSATS global rating and a motion tracking device) Two observers (reliability greater 0.98) Two surgeons (0.99 reliability) Observers Observers Observers

Contextual setting for final assessment Porcine model (pre on box trainer) Porcine model Patients in OR (pre on a simulator) Porcine model Patients in OR (post only. Preassessment was done on simulator and then the training group performed on the simulator again before being evaluated in the OR) Patients in OR (post only) Patients in OR

Citation Aggarwal et al 7 Ahlberg et al 5 Ahlberg et al 23 Andreatta et al 8 Banks et al 35 Bennett et al 1 Gala et al 15

World Journal of Laparoscopic Surgery, September-December 2017;10(3):117-128 123