Objective metrics for hand-sewn bowel anastomoses can differentiate novice from expert surgeons.
Objective metrics for hand-sewn bowel anastomoses can differentiate novice from expert surgeons.
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手工缝制肠吻合术的客观指标可以区分新手和专家外科医生。
DOI：
10.1007/s00464-022-09584-1
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Fleshman,JamesW
中科院分区：
文献类型：
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作者：
Sankaranarayanan,Ganesh;Parker,LisaM;Khan,Aimal;Dials,James;Demirel,Doga;Halic,Tansel;Crawford,Alyson;Kruger,Uwe;De,Suvranu;Fleshman,JamesW
背景在虚拟现实训练器中或根据录制的视频自动评估表现是有利的，但需要经过验证的客观指标。本研究的目的是获得专家共识并验证为评估双层端对端吻合术性能而开发的特定任务指标。材料和方法受试者被招募为专家组（PGY 4-5、结直肠外科住院医师和主治医师）和新手组（PGY 1-3）。计算专家对每个指标项目的加权平均分、完成时间以及使用全局和特定任务指标计算出的总分进行评估。结果共有 43 名专家外科医生对我们的特定任务指标项目进行评分，加权平均值范围为 5 点李克特量表，从 3.33 到 4.5。共有 20 名受试者（10 名新手和 10 名专家）参与了验证研究。新手组完成任务的速度明显慢于有经验的组（37.67±7.09 vs 25.47±7.82 分钟，p=0.001）。此外，总体评分量表（23.47 ± 4.28 vs 28.3 ± 3.85，p= 0.016）和任务特定指标均显示两组之间的表现存在显着差异（38.77 ± 2.83 vs 42.58 ± 4.56p= 0.027）偏最小二乘（PLS）回归。此外，PLS 回归显示，只有两个指标项（保持缝合张力和工具处理）可以可靠地区分各组之间的表现（20.41 ± 2.42 vs 24.28 ± 4.09 vs，p= 0.037）。结论我们的研究表明，我们的任务特定指标具有显着的判别有效性，可用于评估此过程的技术技能。
BackgroundAssessing performance automatically in a virtual reality trainer or from recorded videos is advantageous but needs validated objective metrics. The purpose of this study is to obtain expert consensus and validate task-specific metrics developed for assessing performance in double-layered end-to-end anastomosis.Materials and methodsSubjects were recruited into expert (PGY 4–5, colorectal surgery residents, and attendings) and novice (PGY 1–3) groups. Weighted average scores of experts for each metric item, completion time, and the total scores computed using global and task-specific metrics were computed for assessment.ResultsA total of 43 expert surgeons rated our task-specific metric items with weighted averages ranging from 3.33 to 4.5 on a 5-point Likert scale. A total of 20 subjects (10 novices and 10 experts) participated in validation study. The novice group completed the task significantly more slowly than the experienced group (37.67 ± 7.09 vs 25.47 ± 7.82 min,p= 0.001). In addition, both the global rating scale (23.47 ± 4.28 vs 28.3 ± 3.85,p= 0.016) and the task-specific metrics showed a significant difference in performance between the two groups (38.77 ± 2.83 vs 42.58 ± 4.56p= 0.027) following partial least-squares (PLS) regression. Furthermore, PLS regression showed that only two metric items (Stay suture tension and Tool handling) could reliably differentiate the performance between the groups (20.41 ± 2.42 vs 24.28 ± 4.09 vs,p= 0.037).ConclusionsOur study shows that our task-specific metrics have significant discriminant validity and can be used to evaluate the technical skills for this procedure.