Skill accreditation system for laparoscopic gastroenterologic surgeons in Japan

Area of Science:

• Minimally Invasive Surgery
• Surgical Education
• Quality Improvement in Healthcare

Background:

• The Japan Society for Endoscopic Surgery (JSES) established a formal qualification system in 2004 to standardize and improve endoscopic surgical skills.
• The system aimed to objectively assess surgeon competency through videotaped surgical procedures.

Purpose of the Study:

• To evaluate the effectiveness and impact of the JSES Endoscopic Surgical Skill Qualification System.
• To assess surgeon competency and its correlation with patient outcomes.

Main Methods:

• A double-blinded assessment of non-edited videotapes using common and procedure-specific criteria.
• Evaluation by two independent judges with established scoring rubrics.
• Analysis of accreditation rates and inter-rater reliability over four years.

Main Results:

• Out of 1,114 assessed surgeons, 537 (48.2%) were accredited, with consistent qualification rates (40-50%) across surgical fields.
• Initial low inter-rater agreement (0.31) improved with criteria revision and consensus meetings.
• Qualified surgeons demonstrated significantly fewer complications compared to non-qualified surgeons.

Conclusions:

• The JSES qualification system has successfully contributed to the improvement and standardization of laparoscopic surgery in Japan.
• The system serves as a valuable tool for surgical skill assessment and quality assurance in endoscopic surgery.
• Ongoing refinement of assessment criteria enhances the reliability and validity of surgical skill evaluation.