Effects of experience and reference tools on laparoscopic length measurements

Jackson, Hope T.; Zettervall, Sara L.; Teitelbaum, Ezra N.; Holzner, Matthew L.; Weissler, Jason M.; Amdur, Richard L.; Vaziri, Khashayar

doi:10.1007/s00464-014-3802-5

Cited by 4 publications

(17 citation statements)

References 14 publications

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“…Previous studies investigated the use of different methods for LBLM in preclinical models. Isreb et al investigated the use of IM vs. VJ [17], and Jackson et al investigated the use of PT vs. VJ [18]. In contrast, our study presents a comparison of the novel measurement method of computer-assisted 3D bowel length measurements to all three previously investigated methods.…”

Section: Discussionmentioning

confidence: 89%

“…A thorough literature search for articles describing LRYGB surgery and LBLM was performed. Out of the LBLM methods most commonly mentioned in the literature [13,[16][17][18][20][21][22][23][24][25][26][27], visual judgment (VJ, Fig. 1A), use of instrument markings (IM, Fig.…”

Section: Methods For Laparoscopic Bowel Length Measurementmentioning

confidence: 99%

“…1C). Jackson et al [18] evaluated PT in a phantom model with a group of medical students, residents, and surgical attendings. The study protocol included two LBLMs of 150cm on a 500cm rope with a 10-cm piece of thread [18].…”

Section: Use Of Premeasured Tapementioning

confidence: 99%

“…Jackson et al [18] evaluated PT in a phantom model with a group of medical students, residents, and surgical attendings. The study protocol included two LBLMs of 150cm on a 500cm rope with a 10-cm piece of thread [18]. A literature search yielded five clinical articles mentioning the use of PT [23][24][25][26][27] and one article mentioning the use of a premeasured silk thread for LBLM [28].…”

Section: Use Of Premeasured Tapementioning

confidence: 99%

“…However, an online survey of practicing surgeons in the American Society for Bariatric Surgery revealed that only 53% of bariatric surgeons use a formally objective method (open grasper, premeasured umbilical tape, or suture) to measure the lengths of the constructed bowel limbs [16]. So far, methods for laparoscopic bowel length measurement (LBLM) have not been sufficiently assessed in clinical trials [17,18], and there is no evidence for the superiority of one method of LBLM over the others [19].…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Conventional Methods for Bowel Length Measurement in Laparoscopic Surgery to a Novel Computer-Assisted 3D Measurement System

et al. 2021

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Purpose Accurate laparoscopic bowel length measurement (LBLM), which is used primarily in metabolic surgery, remains a challenge. This study aims to three conventional methods for LBLM, namely using visual judgment (VJ), instrument markings (IM), or premeasured tape (PT) to a novel computer-assisted 3D measurement system (BMS). Materials and Methods LBLM methods were compared using a 3D laparoscope on bowel phantoms regarding accuracy (relative error in percent, %), time in seconds (s), and number of bowel grasps. Seventy centimeters were measured seven times. As a control, the first, third, fifth, and seventh measurements were performed with VJ. The interventions IM, PT, and BMS were performed following a randomized order as the second, fourth, and sixth measurements. Results In total, 63 people participated. BMS showed better accuracy (2.1±3.7%) compared to VJ (8.7±13.7%, p=0.001), PT (4.3±6.8%, p=0.002), and IM (11±15.3%, p<0.001). Participants performed LBLM in a similar amount of time with BMS (175.7±59.7s) and PT (166.5±63.6s, p=0.35), but VJ (64.0±24.0s, p<0.001) and IM (144.9±55.4s, p=0.002) were faster. Number of bowel grasps as a measure for the risk of bowel lesions was similar for BMS (15.8±3.0) and PT (15.9±4.6, p=0.861), whereas VJ required less (14.1±3.4, p=0.004) and IM required more than BMS (22.2±6.9, p<0.001). Conclusions PT had higher accuracy than VJ and IM, and lower number of bowel grasps than IM. BMS shows great potential for more reliable LBLM. Until BMS is available in clinical routine, PT should be preferred for LBLM. Graphical abstract

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Section: Discussionmentioning

confidence: 89%

Section: Methods For Laparoscopic Bowel Length Measurementmentioning

confidence: 99%

Section: Use Of Premeasured Tapementioning

confidence: 99%

Section: Use Of Premeasured Tapementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of Conventional Methods for Bowel Length Measurement in Laparoscopic Surgery to a Novel Computer-Assisted 3D Measurement System

et al. 2021

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Accuracy and inter-operator variability of small bowel length measurement at laparoscopy

et al. 2017

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Laparoscopic Small Bowel Length Measurement in Bariatric Surgery Using a Hand-Over-Hand Technique with Marked Graspers: an Ex Vivo Experiment

et al. 2022

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Introduction Tailoring limb length in bariatric surgery is a subject of many studies. To acquire the optimal limb length, accurate measurement of the small bowel length is essential. Objective To assess the intra- and inter-individual variability of laparoscopic bowel length measurement using a hand-over-hand technique with marked graspers. Method Four bariatric surgeons and four surgical residents performed measurements on cadaver porcine intestine in a laparoscopic box using marked graspers. Each participant performed 10 times a measurement of three different lengths: 150, 180, and 210 cm. Acceptable percentage deviation from the goal lengths was defined as less than 10%, while unacceptable deviations were defined as more than 15%. Results The bariatric surgeons measured the 150-, 180-, and 210-cm tasks with 4% (CI 0.4, 9), − 6% (CI − 11, − 0.8), and 1% (CI − 4, 6) deviation, respectively. In total, the bariatric surgeons estimated 58 out of 119 times (49%) between the margins of 10% deviation and 36 times (30%) outside the 15% margin. Considerable inter-individual differences were found between the surgeons. The surgical residents underestimated the tasks with 12% (CI − 18, − 6), 16% (CI − 19, − 13), and 18% (CI − 22, − 13), respectively. Conclusion Bariatric surgeons estimated bowel length with on average less than 10% deviation. However, this still resulted in 30% of the measurements with more than 15% deviation. There were considerable inter-individual differences between the surgeons and residents structurally underestimated the bowel length. Ascertainment of measurement accuracy and adequate training is essential for bariatric procedures in which limb length is of importance. Graphical abstract

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Effects of experience and reference tools on laparoscopic length measurements

Abstract: These data suggest that use of a measurement tool in laparoscopic length measurement will yield better precision with no effect on operative time or procedural flow in more experienced operators. Standardization of methods of use and optimal training techniques remains to be determined.

Cited by 4 publications

References 14 publications

Comparison of Conventional Methods for Bowel Length Measurement in Laparoscopic Surgery to a Novel Computer-Assisted 3D Measurement System

Comparison of Conventional Methods for Bowel Length Measurement in Laparoscopic Surgery to a Novel Computer-Assisted 3D Measurement System

Accuracy and inter-operator variability of small bowel length measurement at laparoscopy

Laparoscopic Small Bowel Length Measurement in Bariatric Surgery Using a Hand-Over-Hand Technique with Marked Graspers: an Ex Vivo Experiment

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