Quantitative pediatric surgical skill assessment using a rapid-prototyped chest model

Abstract

Introduction: Though minimally invasive pediatric surgery has become more widespread, pediatric-specific surgical skills have not been quantitatively assessed. Material and methods: As a first step toward the quantification of pediatric-specific surgical skills, a pediatric chest model comprising a three-dimensional rapid-prototyped pediatric ribcage with accurate anatomical dimensions, a suturing skin model with force-sensing capability, and forceps with motion-tracking sensors were developed. A skill assessment experiment was conducted by recruiting 16 inexperienced pediatric surgeons and 14 experienced pediatric surgeons to perform an endoscopic intracorporeal suturing and knot-tying task in both the pediatric chest model setup and the conventional box trainer setup. Results: The instrument motion measurement was successful in only 20 surgeons due to sensor failure. The task completion time, total path length of instruments, and applied force were compared between the inexperienced and experienced surgeons as well as between the box trainer and chest model setups. The experienced surgeons demonstrated better performance in all parameters for both setups, and the pediatric chest model was more challenging due to the pediatric features replicated by the model. Conclusion: The pediatric chest model was valid for pediatric skill assessment, and further analysis of the collected data will be conducted to further investigate pediatric-specific skills.

Key words:

• Pediatric
• model
• simulation
• skill assessment
• minimally invasive surgery

Acknowledgments

The authors thank Prof. Yuji Nirasawa of Kyorin University for kindly providing the opportunity to conduct these experiments. The authors also thank Mr. Hisayuki Sugiyama and Ms. Kazumi Shimizu of Ono & Co., Ltd. for their kind help and advice on model fabrication, Masahiro Fujii and Hideyuki Sato for their help during the experiments. This study was partially supported by a Grant-in-Aid for Scientific Research (S) No. 23226006 by the Ministry of Education, Culture, Sports, Science, and Technology, and the project “Assessment methodology for innovative minimally invasive therapeutic devices, materials, and nano-bio diagnostic devices” by the Accelerating Regulatory Science Initiative, Ministry of Health, Labour, and Welfare, Japan.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.