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Author Min Yong Kang, Yong Hyun Park, Hyeon Hoe Kim
Place of duty Department of Urology, Seoul National University College of Medicine, Seoul, Kor
Title Efficacy of the Articulating Laparoscopic Instrument in Laparoscopy-naïve Residents: Comparison with the Conventional Laparoscopic Instrument
Publicationinfo The Korean Journal of Endourology 2008 Jun 30(1) : 42~49
Key Word Laparoscopy, Articulating instrument, Simulator-based training
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Abstract Purpose: To determine if articulating laparoscopic instrument could improve the efficacy of laparoscopic skills in urologic residents without previous laparoscopic surgery. Patients & Methods: 21 urologic residents were enrolled in a simulator-based laparoscopic training program. There were three series of laparoscopic tasks which composite of peg-board task (task 1), curved-line cutting-task (task 2) and suture and knot-tying task (task 3). In task 3, they were divided into two groups. Group 1 (n=11) used an articulating laparoscopic needle holder (CambridgeEndo, Framingham, MA, USA) and group 2 (n=10) used a conventional laparoscopic needle holder (Olympus, Tokyo, Japan). All residents performed each tasks for 10 times, and their proficiency was assessed by performance times (seconds), accuracy of works (Global Rating Scales; Objective Structured Assessment of Technical Skill), angle measurement of right upper arm, and visual analogue scale of pain after work. Results: In task 1 and 2, mean performance time was significantly improved (p<0.05). In task 3, there were no significant differences of performance time, global rating scores of accuracy and total pain scores between group 1 and 2 (p>0.05). However, angle differences of right upper arm and pain scores of right wrist in group 1 was significantly smaller than those of group 2 (p<0.05). Improvement of proficiency in group 2 was bigger than in group 1 (p<0.05). As dividing each group by training year, there were also no significant differences of performance time, global rating scores of accuracy and total pain scores between group1 and 2 (p>0.05). However, residents in lower grade achieved greater improvement in performance time and global scores of accuracy compared with residents in higher grade, irregardless of instruments. Conclusions: The articulating laparoscopic instrument might be more difficult to learn due to the complexity of distal tip-handling. However, it showed similar efficacy with the conventional laparoscopic instrument in performance time, accuracy, and post-work pain. Furthermore, the articulating instrument had some advantages of smaller range of motion of right upper arm and lesser pain of right wrist.
저 자 강민용, 박용현, 김현회
소 속 서울대학교 의과대학 비뇨기과학 교실
제 목 관절화 복강경 기구의 효용성 평가 : 전통적 복강경 기구와의 비교
출판정보 대한 ENDOUROLOGY 학회지 2008 Jun 30(1) : 42~49

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