Construct validity of the SurgForce system for objective assessment of laparoscopic suturing skills
Background Laparoscopic surgery requires a new set of skill to be learned by the surgeons, of which the most relevant is tissue manipulation. Excessive forces applied to the tissue can cause rupture during manipulation or ischemia when confronting both sides of the tissue. The aim of this study is t...
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| Veröffentlicht in: | Surgical endoscopy 2020-11, Vol.34 (11), p.5188-5199 |
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| creator | Montoya-Alvarez, Salvador Minor-Martínez, Arturo Ordorica-Flores, Ricardo Manuel Padilla-Sánchez, Luis Tapia-Jurado, Jesús Pérez-Escamirosa, Fernando |
| description | Background
Laparoscopic surgery requires a new set of skill to be learned by the surgeons, of which the most relevant is tissue manipulation. Excessive forces applied to the tissue can cause rupture during manipulation or ischemia when confronting both sides of the tissue. The aim of this study is to establish the construct validity of the
SurgForce
system for objective assessment of advanced laparoscopic skills, based on the force signal generated during suture tasks, and the development of force parameters for evaluating tissue handling interaction.
Methods
The
SurgForce
system, a tissue handling training device that measures dynamic force, was used to capture the force generated by surgeons with different levels of laparoscopic experience. For construct validity, 37 participants were enrolled in this study: 19 medical students, 12 residents of surgical specialties and 6 expert surgeons. All participants performed an
intracorporeal knotting suture
task over a synthetic tissue pad with a laparoscopic box-trainer. The force performance of the participants was analyzed using 11 force-based parameters with the application of the
SurgForce
system. Statistical analysis was performed between novice, intermediate, and expert groups using a Kruskal–Wallis test, and between the pairs of groups using a Mann–Whitney
U
–test.
Results
Overall, 9 of the 11 force-related parameters showed significant differences between the three study groups. Results between the pairs of groups presented significant differences in 5 force parameters proposed. Construct validity results demonstrated that the
SurgForce
system was able to differentiate force performance between surgeons with different levels of laparoscopic experience.
Conclusion
The
SurgForce
system was successfully validated. This force system showed its potential to measure the force exerted on tissue for objective assessment of tissue handling skills in suturing tasks. Furthermore, its compact design allows the use of this device in conventional laparoscopic box-trainers. |
| doi_str_mv | 10.1007/s00464-020-07873-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2434755504</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2434755504</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2901-5cd35804ff9698a43c70ced53615f3184fa19cb510958a36468a39fd301a6093</originalsourceid><addsrcrecordid>eNp9kUtP3DAUha2qVRmgf6ALZKmbbkKvX0m8rEalICGxgL3lcWyaaRIHXwdp_j0ehoLUBZt7N98593EI-crgnAE0PxBA1rICDhU0bSMq9oGsmBS84py1H8kKtICKN1oekWPELRReM_WZHAneguS1XhG3jhPmtLhMH-3Qd33e0Rho_uPp7ZLuL2JynuIOsx9piInGzda73D96ahE94uinvBcMdrYpootz7ygueUn9dE_xbz8MeEo-BTug__LST8jdxa-79WV1ffP7av3zunJcA6uU64Qqe4Wga91aKVwDzndK1EwFwVoZLNNuoxho1VpRy7pUHToBzNbl1BPy_WA7p_iweMxm7NH5YbCTjwsaLoVslFIgC_rtP3QblzSV5QxvuOatBOCF4gfKlcsw-WDm1I827QwDs0_AHBIwJQHznIBhRXT2Yr1sRt-9Sv69vADiAOC8_5FPb7PfsX0CdC6Q8w</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2729284002</pqid></control><display><type>article</type><title>Construct validity of the SurgForce system for objective assessment of laparoscopic suturing skills</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Montoya-Alvarez, Salvador ; Minor-Martínez, Arturo ; Ordorica-Flores, Ricardo Manuel ; Padilla-Sánchez, Luis ; Tapia-Jurado, Jesús ; Pérez-Escamirosa, Fernando</creator><creatorcontrib>Montoya-Alvarez, Salvador ; Minor-Martínez, Arturo ; Ordorica-Flores, Ricardo Manuel ; Padilla-Sánchez, Luis ; Tapia-Jurado, Jesús ; Pérez-Escamirosa, Fernando</creatorcontrib><description>Background
Laparoscopic surgery requires a new set of skill to be learned by the surgeons, of which the most relevant is tissue manipulation. Excessive forces applied to the tissue can cause rupture during manipulation or ischemia when confronting both sides of the tissue. The aim of this study is to establish the construct validity of the
SurgForce
system for objective assessment of advanced laparoscopic skills, based on the force signal generated during suture tasks, and the development of force parameters for evaluating tissue handling interaction.
Methods
The
SurgForce
system, a tissue handling training device that measures dynamic force, was used to capture the force generated by surgeons with different levels of laparoscopic experience. For construct validity, 37 participants were enrolled in this study: 19 medical students, 12 residents of surgical specialties and 6 expert surgeons. All participants performed an
intracorporeal knotting suture
task over a synthetic tissue pad with a laparoscopic box-trainer. The force performance of the participants was analyzed using 11 force-based parameters with the application of the
SurgForce
system. Statistical analysis was performed between novice, intermediate, and expert groups using a Kruskal–Wallis test, and between the pairs of groups using a Mann–Whitney
U
–test.
Results
Overall, 9 of the 11 force-related parameters showed significant differences between the three study groups. Results between the pairs of groups presented significant differences in 5 force parameters proposed. Construct validity results demonstrated that the
SurgForce
system was able to differentiate force performance between surgeons with different levels of laparoscopic experience.
Conclusion
The
SurgForce
system was successfully validated. This force system showed its potential to measure the force exerted on tissue for objective assessment of tissue handling skills in suturing tasks. Furthermore, its compact design allows the use of this device in conventional laparoscopic box-trainers.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-020-07873-1</identifier><identifier>PMID: 32804269</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Clinical Competence ; Female ; Gastroenterology ; Gynecology ; Hepatology ; Humans ; Laparoscopy ; Laparoscopy - education ; Laparoscopy - instrumentation ; Male ; Mechanical Phenomena ; Medicine ; Medicine & Public Health ; Neurosurgical Procedures ; New Technology ; Proctology ; Reproducibility of Results ; Skills ; Surgery ; Suture Techniques - education ; Suture Techniques - instrumentation ; Sutures ; Validation studies ; Validity</subject><ispartof>Surgical endoscopy, 2020-11, Vol.34 (11), p.5188-5199</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020</rights><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2901-5cd35804ff9698a43c70ced53615f3184fa19cb510958a36468a39fd301a6093</citedby><cites>FETCH-LOGICAL-c2901-5cd35804ff9698a43c70ced53615f3184fa19cb510958a36468a39fd301a6093</cites><orcidid>0000-0002-9906-3639 ; 0000-0001-7886-8692 ; 0000-0001-5365-5957 ; 0000-0001-6329-7356</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-020-07873-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-020-07873-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32804269$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Montoya-Alvarez, Salvador</creatorcontrib><creatorcontrib>Minor-Martínez, Arturo</creatorcontrib><creatorcontrib>Ordorica-Flores, Ricardo Manuel</creatorcontrib><creatorcontrib>Padilla-Sánchez, Luis</creatorcontrib><creatorcontrib>Tapia-Jurado, Jesús</creatorcontrib><creatorcontrib>Pérez-Escamirosa, Fernando</creatorcontrib><title>Construct validity of the SurgForce system for objective assessment of laparoscopic suturing skills</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
Laparoscopic surgery requires a new set of skill to be learned by the surgeons, of which the most relevant is tissue manipulation. Excessive forces applied to the tissue can cause rupture during manipulation or ischemia when confronting both sides of the tissue. The aim of this study is to establish the construct validity of the
SurgForce
system for objective assessment of advanced laparoscopic skills, based on the force signal generated during suture tasks, and the development of force parameters for evaluating tissue handling interaction.
Methods
The
SurgForce
system, a tissue handling training device that measures dynamic force, was used to capture the force generated by surgeons with different levels of laparoscopic experience. For construct validity, 37 participants were enrolled in this study: 19 medical students, 12 residents of surgical specialties and 6 expert surgeons. All participants performed an
intracorporeal knotting suture
task over a synthetic tissue pad with a laparoscopic box-trainer. The force performance of the participants was analyzed using 11 force-based parameters with the application of the
SurgForce
system. Statistical analysis was performed between novice, intermediate, and expert groups using a Kruskal–Wallis test, and between the pairs of groups using a Mann–Whitney
U
–test.
Results
Overall, 9 of the 11 force-related parameters showed significant differences between the three study groups. Results between the pairs of groups presented significant differences in 5 force parameters proposed. Construct validity results demonstrated that the
SurgForce
system was able to differentiate force performance between surgeons with different levels of laparoscopic experience.
Conclusion
The
SurgForce
system was successfully validated. This force system showed its potential to measure the force exerted on tissue for objective assessment of tissue handling skills in suturing tasks. Furthermore, its compact design allows the use of this device in conventional laparoscopic box-trainers.</description><subject>Abdominal Surgery</subject><subject>Clinical Competence</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Laparoscopy - education</subject><subject>Laparoscopy - instrumentation</subject><subject>Male</subject><subject>Mechanical Phenomena</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neurosurgical Procedures</subject><subject>New Technology</subject><subject>Proctology</subject><subject>Reproducibility of Results</subject><subject>Skills</subject><subject>Surgery</subject><subject>Suture Techniques - education</subject><subject>Suture Techniques - instrumentation</subject><subject>Sutures</subject><subject>Validation studies</subject><subject>Validity</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kUtP3DAUha2qVRmgf6ALZKmbbkKvX0m8rEalICGxgL3lcWyaaRIHXwdp_j0ehoLUBZt7N98593EI-crgnAE0PxBA1rICDhU0bSMq9oGsmBS84py1H8kKtICKN1oekWPELRReM_WZHAneguS1XhG3jhPmtLhMH-3Qd33e0Rho_uPp7ZLuL2JynuIOsx9piInGzda73D96ahE94uinvBcMdrYpootz7ygueUn9dE_xbz8MeEo-BTug__LST8jdxa-79WV1ffP7av3zunJcA6uU64Qqe4Wga91aKVwDzndK1EwFwVoZLNNuoxho1VpRy7pUHToBzNbl1BPy_WA7p_iweMxm7NH5YbCTjwsaLoVslFIgC_rtP3QblzSV5QxvuOatBOCF4gfKlcsw-WDm1I827QwDs0_AHBIwJQHznIBhRXT2Yr1sRt-9Sv69vADiAOC8_5FPb7PfsX0CdC6Q8w</recordid><startdate>20201101</startdate><enddate>20201101</enddate><creator>Montoya-Alvarez, Salvador</creator><creator>Minor-Martínez, Arturo</creator><creator>Ordorica-Flores, Ricardo Manuel</creator><creator>Padilla-Sánchez, Luis</creator><creator>Tapia-Jurado, Jesús</creator><creator>Pérez-Escamirosa, Fernando</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9906-3639</orcidid><orcidid>https://orcid.org/0000-0001-7886-8692</orcidid><orcidid>https://orcid.org/0000-0001-5365-5957</orcidid><orcidid>https://orcid.org/0000-0001-6329-7356</orcidid></search><sort><creationdate>20201101</creationdate><title>Construct validity of the SurgForce system for objective assessment of laparoscopic suturing skills</title><author>Montoya-Alvarez, Salvador ; Minor-Martínez, Arturo ; Ordorica-Flores, Ricardo Manuel ; Padilla-Sánchez, Luis ; Tapia-Jurado, Jesús ; Pérez-Escamirosa, Fernando</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2901-5cd35804ff9698a43c70ced53615f3184fa19cb510958a36468a39fd301a6093</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Abdominal Surgery</topic><topic>Clinical Competence</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Laparoscopy - education</topic><topic>Laparoscopy - instrumentation</topic><topic>Male</topic><topic>Mechanical Phenomena</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neurosurgical Procedures</topic><topic>New Technology</topic><topic>Proctology</topic><topic>Reproducibility of Results</topic><topic>Skills</topic><topic>Surgery</topic><topic>Suture Techniques - education</topic><topic>Suture Techniques - instrumentation</topic><topic>Sutures</topic><topic>Validation studies</topic><topic>Validity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Montoya-Alvarez, Salvador</creatorcontrib><creatorcontrib>Minor-Martínez, Arturo</creatorcontrib><creatorcontrib>Ordorica-Flores, Ricardo Manuel</creatorcontrib><creatorcontrib>Padilla-Sánchez, Luis</creatorcontrib><creatorcontrib>Tapia-Jurado, Jesús</creatorcontrib><creatorcontrib>Pérez-Escamirosa, Fernando</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Montoya-Alvarez, Salvador</au><au>Minor-Martínez, Arturo</au><au>Ordorica-Flores, Ricardo Manuel</au><au>Padilla-Sánchez, Luis</au><au>Tapia-Jurado, Jesús</au><au>Pérez-Escamirosa, Fernando</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Construct validity of the SurgForce system for objective assessment of laparoscopic suturing skills</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2020-11-01</date><risdate>2020</risdate><volume>34</volume><issue>11</issue><spage>5188</spage><epage>5199</epage><pages>5188-5199</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Background
Laparoscopic surgery requires a new set of skill to be learned by the surgeons, of which the most relevant is tissue manipulation. Excessive forces applied to the tissue can cause rupture during manipulation or ischemia when confronting both sides of the tissue. The aim of this study is to establish the construct validity of the
SurgForce
system for objective assessment of advanced laparoscopic skills, based on the force signal generated during suture tasks, and the development of force parameters for evaluating tissue handling interaction.
Methods
The
SurgForce
system, a tissue handling training device that measures dynamic force, was used to capture the force generated by surgeons with different levels of laparoscopic experience. For construct validity, 37 participants were enrolled in this study: 19 medical students, 12 residents of surgical specialties and 6 expert surgeons. All participants performed an
intracorporeal knotting suture
task over a synthetic tissue pad with a laparoscopic box-trainer. The force performance of the participants was analyzed using 11 force-based parameters with the application of the
SurgForce
system. Statistical analysis was performed between novice, intermediate, and expert groups using a Kruskal–Wallis test, and between the pairs of groups using a Mann–Whitney
U
–test.
Results
Overall, 9 of the 11 force-related parameters showed significant differences between the three study groups. Results between the pairs of groups presented significant differences in 5 force parameters proposed. Construct validity results demonstrated that the
SurgForce
system was able to differentiate force performance between surgeons with different levels of laparoscopic experience.
Conclusion
The
SurgForce
system was successfully validated. This force system showed its potential to measure the force exerted on tissue for objective assessment of tissue handling skills in suturing tasks. Furthermore, its compact design allows the use of this device in conventional laparoscopic box-trainers.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>32804269</pmid><doi>10.1007/s00464-020-07873-1</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-9906-3639</orcidid><orcidid>https://orcid.org/0000-0001-7886-8692</orcidid><orcidid>https://orcid.org/0000-0001-5365-5957</orcidid><orcidid>https://orcid.org/0000-0001-6329-7356</orcidid></addata></record> |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Abdominal Surgery Clinical Competence Female Gastroenterology Gynecology Hepatology Humans Laparoscopy Laparoscopy - education Laparoscopy - instrumentation Male Mechanical Phenomena Medicine Medicine & Public Health Neurosurgical Procedures New Technology Proctology Reproducibility of Results Skills Surgery Suture Techniques - education Suture Techniques - instrumentation Sutures Validation studies Validity |
| title | Construct validity of the SurgForce system for objective assessment of laparoscopic suturing skills |
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