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Systematic Review of Intraoperative Assessment Tools in Minimally Invasive Gynecologic Surgery
J Stuart Ferriss1, Anja S Frost1, Alison Brooks Heinzman1
1Kelly Gynecologic Oncology Service (Dr. Ferriss); Division of Urogynecology (Dr. Patterson); Division of Gynecologic Specialties (Dr. Patzkowsky); Department of Gynecology and Obstetrics (Drs. Frost and Bienstock); Welch Medical Library (Ms. Blanck), Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Women's Health, Dell School of Medicine, University of Texas at Austin, Austin, Texas (Drs. Heinzman and Tsai).
Objective:
To collect, summarize, and evaluate the currently available intraoperative rating tools used in abdominal minimally invasive gynecologic surgery (MIGS).
Data Sources:
Medline, Embase, and Scopus databases from January 1, 2000, to May 12, 2020.
Methods Of Study Selection:
A systematic search strategy was designed and executed. Published studies evaluating an assessment tool in abdominal MIGS cases were included. Studies focused on simulation, reviews, and abstracts without a published manuscript were excluded. Risk of bias and methodological quality were assessed for each study.
Tabulation, Integration, And Results:
Disparate study methods prevented quantitative synthesis of the data. Ten studies were included in the analysis. The tools were grouped into global (n = 4) and procedure-specific assessments (n = 6). Most studies evaluated small numbers of surgeons and lacked a comparison group to evaluate the effectiveness of the tool. All studies demonstrated content validity and at least 1 dimension of reliability, and 2 have external validity. The intraoperative procedure-specific tools have been more thoroughly evaluated than the global scales.
Conclusion:
Procedure-specific intraoperative assessment tools for MIGS cases are more thoroughly evaluated than global tools; however, poor-quality studies and borderline reliability limit their use. Well-designed, controlled studies evaluating the effectiveness of intraoperative assessment tools in MIGS are needed.
