Effect of training and instrument type on performance in single-incision laparoscopy: Results of a randomized comparison using a surgical simulator

Santos, Byron F.; Reif, Taylor J.; Soper, Nathaniel J.; Hungness, Eric S.

doi:10.1007/s00464-011-1791-1

Cited by 39 publications

(25 citation statements)

References 14 publications

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“…After completing three tasks of increasing difficulty, most of the CLS students (87%) were able to perform laparoscopic knot-tying, whereas this was accomplished by only 23% and 7% of the students, respectively, in the SPLS groups. This finding is consistent with the results of a previous study in which learning curves of novices appeared to be significantly longer for SILS techniques than for CLS procedures irrespective of the instruments used (straight, static-articulating, or dynamic-articulating) [6].…”

Section: Discussionsupporting

confidence: 93%

“…Another group found conflicting data showing task scores of CLS compared with several single-port systems that did not differ significantly [7]. This might be attributed on the one hand to a relatively simple task (peg transfer) that had to be performed but on the other hand to the deployment of an internal camera rather than an operator-driven camera, which does not emulate the inherent instrument-camera clashing that occurs with clinical SILS (as stated by [6]). However, this is the first study to demonstrate the significant structural differences (i.e., the inherent enhanced difficulties in performance) of SPLS versus CLS in a large group of novice subjects.…”

Section: Discussionmentioning

confidence: 90%

“…In conclusion, it was shown that SILS is more technically challenging than CLS, with even surgeons who had SILS experience unable to match their overall CLS performance. In a study that included 45 novices (medical students), the same team found that CLS technique results in superior task performance with a shorter learning curve during a standardized training period [6]. Another group found conflicting data showing task scores of CLS compared with several single-port systems that did not differ significantly [7].…”

Section: Discussionmentioning

confidence: 97%

See 2 more Smart Citations

Pre-bent instruments used in single-port laparoscopic surgery versus conventional laparoscopic surgery: comparative study of performance in a dry lab

et al. 2012

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Although SILS is feasible, as shown in clinical series published by laparoscopically experienced experts, SILS techniques are demanding due to restrictions that come with the loss of triangulation. These can be compensated only partially by currently available SILS-designed instruments. The future of SILS depends on further improvements in the available equipment or the development of new approaches such as needlescopically assisted or robotically assisted procedures.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 97%

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Pre-bent instruments used in single-port laparoscopic surgery versus conventional laparoscopic surgery: comparative study of performance in a dry lab

et al. 2012

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“…The fellows involved in the study did have prior experience in advanced multiport laparoscopic procedures, but their median operating time was similar to the time required by residents. These difficulties of conventional laparoscopic proficient surgeons to translate these skills to SILS have also been reported by three laboratory-based studies comparing laparoscopic-and SILS-trained candidates [16][17][18]. Pucher et al concluded that the skills required for SILS are not automatically acquired through multiport laparoscopic experience [19].…”

Section: Discussionmentioning

confidence: 93%

The Influence of Training Levels and Surgical Experience on Outcomes after Single-Incision Laparoscopic Appendectomy

Raakow¹,

Liesaus²,

Raakow³

2015

Surgery

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IntroductionOver the last thirty years, laparoscopic appendectomy has gained wide acceptance as the surgical procedure of choice for patients with acute or chronic appendicitis. A shorter hospital stay, earlier return to work and activity, better wound healing, and less postoperative pain are now well known reasons for the transition from laparotomy to laparoscopy. These benefits raise the question as to whether more minimalized surgery would offer patients even greater benefits. Therefore, single-incision laparoscopic surgery (SILS) has raised tremendous interest among surgeons in the last few years, and has emerged as a serious alternative to conventional multiport laparoscopy. Although larger series and extended follow-up analyses are still missing and may well provide valuable additional information regarding postoperative outcomes, several studies have demonstrated the technical feasibility and safety of single-incision laparoscopic appendectomy (SILA) [1][2][3][4][5][6].Experienced laparoscopic surgeons were reported to have a short learning curve for SILS. As senior surgeons are becoming increasingly familiar with the technique, it is being incorporated in surgical training as well. Appendectomy is one of the most common surgical procedures performed worldwide [7]. Being one of the most basic laparoscopic procedures in general surgery, it is mainly performed by residents. The influence of resident involvement in surgery and postoperative care is controversially discussed. It is reported to be associated with longer operating times, higher costs, and higher complications rates [8][9][10]. However, it has also been reported to exert a protective effect on the patients' outcome [11]. Little is known about the effect of residentperformed SILA on intraoperative and postoperative outcomes. The purpose of the present study was to determine resident performance and postoperative outcomes in patients undergoing SILA performed by a resident versus SILA performed by an experienced laparoscopic surgeon. Material and MethodsWe performed a review of all patients who underwent singleincision laparoscopic appendectomy between July 2009 and January 2014 at Vivantes Klinikum Am Urban in Berlin, Germany. Patients who underwent appendectomy as part of another single-incision laparoscopic procedure were excluded from the study. Patients with primary multiport laparoscopic or open appendectomy were also excluded. Demographic data included age, gender, weight, height, body mass index (BMI), the American Society of Anesthesiologists score (ASA score), preoperative comorbidities, previous abdominal surgery, and laboratory data concerning leukocytes and C-reactive protein (CRP) on admission. Details of surgery included operating time, the need for conversion to multiport laparoscopy or the open procedure and the reasons for conversion, intraoperative findings such AbstractBackground: Single-incision laparoscopic appendectomy (SILA) has become an accepted alternative to conventional multiport laparoscopic appendectomy. Yet, little...

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“…The idea of SIL was irst proposed as a manual procedure, and grew into a daily surgical routine for general surgery in particular, especially for transoral, transanal, and transvaginal interventions [68][69][70]. The majority of manual SIL procedures were carried out using a single instrument for intervention, as laparoscopic SIL was found with compromised practicality, where the surgeon had to either reverse the motion of the instrument tips or cross his/her own hands to accommodate the immobilizing incision point, being a very counterintuitive exhaustive motoring task to add to the mental burden for the surgeon [71]. However, various studies have pointed out that, after proper training, the eicacy for laparoscopic SIL is at least as good as standard laparoscopy [72][73][74].…”

Section: Innovations For Accessibility: Sil and Notesmentioning

confidence: 99%

The Next-Generation Surgical Robots

Wang¹,

Liu²,

Peng³

et al. 2018

Surgical Robotics

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The chronicle of surgical robots is short but remarkable. Within 20 years since the regulatory approval of the irst surgical robot, more than 3,000 units were installed worldwide, and more than half a million robotic surgical procedures were carried out in the past year alone. The exceptionally high speeds of market penetration and expansion to new surgical areas had raised technical, clinical, and ethical concerns. However, from a technological perspective, surgical robots today are far from perfect, with a list of improvements expected for the next-generation systems. On the other hand, robotic technologies are lourishing at ever-faster paces. Without the inherent conservation and safety requirements in medicine, general robotic research could be substantially more agile and explorative. As a result, various technical innovations in robotics developed in recent years could potentially be grafted into surgical applications and ignite the next major advancement in robotic surgery. In this article, the current generation of surgical robots is reviewed from a technological point of view, including three of possibly the most debated technical topics in surgical robotics: vision, haptics, and accessibility. Further to that, several emerging robotic technologies are highlighted for their potential applications in next-generation robotic surgery.

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Effect of training and instrument type on performance in single-incision laparoscopy: Results of a randomized comparison using a surgical simulator

Cited by 39 publications

References 14 publications

Pre-bent instruments used in single-port laparoscopic surgery versus conventional laparoscopic surgery: comparative study of performance in a dry lab

Pre-bent instruments used in single-port laparoscopic surgery versus conventional laparoscopic surgery: comparative study of performance in a dry lab

The Influence of Training Levels and Surgical Experience on Outcomes after Single-Incision Laparoscopic Appendectomy

The Next-Generation Surgical Robots

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