Assessment of Minimally Invasive Suturing Skills: Is Instrument Tracking an Accurate Prediction?

Area of Science:

• Surgical Education and Training
• Medical Simulation
• Objective Skill Assessment

Background:

• Minimally invasive surgery (MIS) requires advanced suturing skills, necessitating effective training and assessment methods.
• Current assessment relies on expert judgment or objective parameters like instrument tracking.
• The study investigates the correlation between objective parameters and expert assessment in MIS suturing.

Purpose of the Study:

• To evaluate the extent to which objective instrument tracking parameters correlate with expert assessments of MIS suturing skills.
• To determine the efficacy of objective parameters in providing a reliable assessment of surgical skill acquisition.

Main Methods:

• Participants performed intracorporeal suturing tasks on the EoSim simulator.
• Objective parameters (time, distance) were tracked and combined into a composite score.
• Videos were assessed by blinded expert reviewers using the laparoscopic suturing competency assessment tool (LS-CAT).

Main Results:

• Objective parameters (time, distance) showed significant correlation with LS-CAT domains.
• Both objective composite scores and LS-CAT scores improved with training.
• The correlation between the composite score and LS-CAT scores was weak (R: 0.351), with limited accuracy (55/100).

Conclusions:

• Instrument tracking parameters offer an indication of skill level but miss crucial elements for comprehensive assessment.
• Expert assessment remains superior for reliably determining skill levels in MIS suturing.
• Objective parameters alone are insufficient for a complete and reliable evaluation of MIS suturing proficiency.