ANALYSIS OF FORCES IN LAPAROSCOPY: THE DECONSTRUCTION OF AN INTRACORPOREAL SUTURING TASK

You have accessJournal of UrologySurgical Technology & Simulation: Training & Skills Assessment II (MP35)1 Apr 2019MP35-12 ANALYSIS OF FORCES IN LAPAROSCOPY: THE DECONSTRUCTION OF AN INTRACORPOREAL SUTURING TASK Kai-Ho Fok*, Sophia Duong, Brian Carrillo, J. Ted Gerstle, Georges Azzie, and Monica A. Farcas Kai-Ho Fok*Kai-Ho Fok* More articles by this author , Sophia DuongSophia Duong More articles by this author , Brian CarrilloBrian Carrillo More articles by this author , J. Ted GerstleJ. Ted Gerstle More articles by this author , Georges AzzieGeorges Azzie More articles by this author , and Monica A. FarcasMonica A. Farcas More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556002.17617.21AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: An intracorporeal suturing task simulator has been developed that can measure forces in real time during the performance of the task. These forces have been described and have been shown to be greater in larger size simulators. We analyze the forces on deconstructed task segments to allow for targeted assessment and teaching. METHODS: Participants performed a defined intracorporeal suturing task on a pediatric (PLS) simulator. Expertise level was assigned based on number of laparoscopic cases. Real-time force and torque data were collected in 3 degrees of freedom using a custom-designed force sensing platform. The task was deconstructed into four segments: loading needle/pull-through, double-throw knot, first single-throw knot, and second single-throw knot. Force analysis parameters (FAPs) were calculated for each of the segments. FAPs included maximum, mean, and number of extreme force events. Outcomes were analyzed using one-way ANOVAs and paired sample t-tests (p<0.05). RESULTS: One-hundred two participants were recorded (20 experts, 52 intermediates, 30 novices). The largest differences were seen in the “double-throw knot segment”. In this segment, significant differences were identified between expert and novices in mean forces exerted in the “side-to-side” direction. Experts exerted a mean force to the right whereas novices exerted a mean force to the left. Congruently, differences were also seen in this segment between novices, intermediates, and experts in the torque applied in the “side-to-side axis”. Experts applied significantly more torque towards the right than novices and intermediates. Similar differences were not found in other segments. In the “first single throw segment”, the novices had a significantly larger number of extreme force events in the “up-and-down” direction. Analyzing maximum forces did not demonstrate any significant differences between the groups in any segment. CONCLUSIONS: We demonstrate an ability to detect real-time assessment of forces during the performance of an intracorporeal suturing task. Deconstruction of the task into segments allows us to gain insight into the specific forces applied which distinguish expertise level. Further studies on forces applied during specific laparoscopic maneuvers may reveal greater insights that distinguish experts and allow for teaching in a more focused and effective manner. Source of Funding: None Toronto, Canada© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e510-e510 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kai-Ho Fok* More articles by this author Sophia Duong More articles by this author Brian Carrillo More articles by this author J. Ted Gerstle More articles by this author Georges Azzie More articles by this author Monica A. Farcas More articles by this author Expand All Advertisement PDF downloadLoading ...