논문검색
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 |
Full Text | PDF Download |
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 |