Continuous Skill Training Using the Disease-Specific Endoscopic Surgical Simulator to Promote Young Pediatric Surgeons: Learning Curve for Trainees

Fukuta, Atsuhisa; Obata, Satoshi; Jimbo, Takahiro; Kono, Jun; Souzaki, Ryota; Matsuoka, Noriyuki; Katayama, Tamotsu; Taguchi, Tomoaki

doi:10.1089/lap.2019.0111

Cited by 4 publications

(1 citation statement)

References 17 publications

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“…35,36 Two-and three-dimensional training models ranging from simple shoebox-setups 37 to animal models 36,38 have been proposed and evaluated to increase exposure to MIS and help surgeons acquire the necessary skills outside of the operating room. 39 Studies have demonstrated that MIS skills -especially the training of intracorporal suturing and knottying in simulator settings-successfully transfer to the operating room, 36,40 suggesting that some of the early phase of the learning curve can be achieved outside of the OR and consequently minimize the effect of the learning curve on the patient's outcome.…”

Section: Trainees 31 Consultants 12mentioning

confidence: 99%

Minimally Invasive Pediatric Surgery: The Learning Curve

et al. 2020

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The use of minimally invasive surgery (MIS) in pediatric patients has increased over the past decades. The process of mastering a new procedure is termed the learning curve, during which the ability to operate increases but poorer outcomes are produced. We aim to analyze the current evidence on learning curves in pediatric MIS and evaluate its impact on patient's clinical outcomes. A systematic literature search was performed for studies listed on PubMed that reported on the learning curve for MIS surgical procedures. Studies were included if they stated the number of procedures required to reach a consistency in outcomes or if they compared outcomes between early and late period of MIS experience regarding the endpoints operative time, conversions, and intra-/postoperative complications. A total of 22 articles reporting on 11 surgical procedures were included in the study. Most authors reported a significant decrease in operative time as well as peri- and postoperative complications with increasing experience of the surgeon. Complications ranged from minor to major, the latter being especially severe for patients receiving pyloromyotomy (5–7% higher risk of mucosal perforation), esophageal atresia repair (15% higher leakage rate and 19–77% higher stenosis rate), or Kasai portoenterostomy (26–35% more liver transplants in the first year after surgery) during the learning curve period. Pediatric MIS comes with a considerable learning curve that may have a significant impact on the patient's clinical outcomes. Efforts should be made to minimize the effect of the learning curve on the patients.

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Section: Trainees 31 Consultants 12mentioning

confidence: 99%

Minimally Invasive Pediatric Surgery: The Learning Curve

et al. 2020

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Involvement of a skill-qualified surgeon favorably influences outcomes of laparoscopic cholecystectomy performed for acute cholecystitis

et al. 2022

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Artificial intelligence facilitates the potential of simulator training: An innovative laparoscopic surgical skill validation system using artificial intelligence technology

Fukuta,

Yamashita,

Maniwa

et al. 2024

Int J CARS

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Purpose The development of innovative solutions, such as simulator training and artificial intelligence (AI)-powered tutoring systems, has significantly changed surgical trainees’ environments to receive the intraoperative instruction necessary for skill acquisition. In this study, we developed a new objective assessment system using AI for forceps manipulation in a surgical training simulator. Methods Laparoscopic exercises were recorded using an iPad®, which provided top and side views. Top-view movies were used for AI learning of forceps trajectory. Side-view movies were used as supplementary information to assess the situation. We used an AI-based posture estimation method, DeepLabCut (DLC), to recognize and positionally measure the forceps in the operating field. Tracking accuracy was quantitatively evaluated by calculating the pixel differences between the annotation points and the points predicted by the AI model. Tracking stability at specified key points was verified to assess the AI model. Results We selected a random sample to evaluate tracking accuracy quantitatively. This sample comprised 5% of the frames not used for AI training from the complete set of video frames. We compared the AI detection positions and correct positions and found an average pixel discrepancy of 9.2. The qualitative evaluation of the tracking stability was good at the forceps hinge; however, forceps tip tracking was unstable during rotation. Conclusion The AI-based forceps tracking system can visualize and evaluate laparoscopic surgical skills. Improvements in the proposed system and AI self-learning are expected to enable it to distinguish the techniques of expert and novice surgeons accurately. This system is a useful tool for surgeon training and assessment.

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Continuous Skill Training Using the Disease-Specific Endoscopic Surgical Simulator to Promote Young Pediatric Surgeons: Learning Curve for Trainees

Cited by 4 publications

References 17 publications

Minimally Invasive Pediatric Surgery: The Learning Curve

Minimally Invasive Pediatric Surgery: The Learning Curve

Involvement of a skill-qualified surgeon favorably influences outcomes of laparoscopic cholecystectomy performed for acute cholecystitis

Artificial intelligence facilitates the potential of simulator training: An innovative laparoscopic surgical skill validation system using artificial intelligence technology

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