A new innovative laparoscopic fundoplication training simulator with a surgical skill validation system

Abstract

We developed and validated a specific laparoscopic fundoplication simulator for use with the objective endoscopic surgical skills evaluation system. The aim of this study was to verify the quality of skills of surgeons. We developed a 1-year-old infant body model based on computed tomography data and reproduced pneumoperitoneum model based on the clinical situation. The examinees were divided into three groups: fifteen pediatric surgery experts (PSE), twenty-four pediatric surgery trainees (PSN), and ten general surgeons (GS). They each had to perform three sutures ligatures for construction of Nissen wrap. Evaluate points are time for task, the symmetry of the placement of the sutures, and the uniformity of the interval of suture ligatures in making wrap. And the total path length and velocity of forceps were measured to assess bi-hand coordination. PSE were significantly superior to PSN regarding total time spent (p<0.01) and total path length (p<0.01). GS used both forceps faster than the other groups, and PSN used the right forceps faster than the left forceps (p<0.05). PSE were shorter with regard to the total path length than GS (p<0.01). PSE showed most excellent results in the symmetry of the wrap among three groups. Our new model was used useful to validate the characteristics between GS and pediatric surgeon. Both PSE and GS have excellent bi-hand coordination and can manipulate both forceps equally and had superior skills compared to PSN. In addition, PSE performed most compact and accurate skills in the conflicted operative space.