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Published on: May 1, 2020
Analysis of laparoscopic dissection skill by instrument tip force measurement
Kenji Yoshida1, Hidefumi Kinoshita, Yoshihiro Kuroda
1Department of Urology and Andrology, Graduate School of Medicine, Kansai Medical University, 2-3-1 Shinmachi Hirakatashi, Osaka, 573-1191, Japan. yoshidke@gaea.ocn.ne.jp
Surgical Endoscopy
|January 25, 2013
Summary
Expert surgeons use efficient force patterns during dissection. Measuring instrument tip force can improve laparoscopic surgical training and safety margins.
Area of Science:
- Surgical Skill Assessment
- Laparoscopic Surgery
- Biomechanics
Background:
- Significant force variations exist in laparoscopic dissection based on surgeon experience.
- Quantifying force patterns is crucial for training and intuitive understanding of dissection techniques.
Purpose of the Study:
- To quantify force patterns during single-stroke laparoscopic dissection.
- To identify expertise-related factors influencing dissection force and timing.
Main Methods:
- Recorded vertical force (VF) and horizontal force (HF) at the instrument tip using a box trainer.
- Compared force parameters and dissection time (T) among expert, intermediate, and novice surgeons (n=10 each).
- Evaluated timing of peak vertical force (TPV) and peak horizontal force (TPH).
Main Results:
- Expert surgeons exhibited the shortest dissection time (T) and smallest average maximum VF and HF.
- TPV consistently preceded TPH across all groups.
- TPV occurred significantly earlier in experts compared to intermediate and novice surgeons, correlating with experience.
Conclusions:
- Expert surgeons utilize efficient force application, initiating dissection with vertical force then transitioning to horizontal force.
- Instrument tip force measurement offers a valuable tool for enhancing understanding and improving the safety of laparoscopic dissection.
