Abstract
Background
Laparoscopic suturing (LS) has become a common technique used in a variety of advanced laparoscopic procedures. However, LS is a challenging skill to master, and many trainees may not be competent in performing LS at the end of their training. The purpose of this review is to identify simulation platforms available for assessment of LS skills, and determine the characteristics of the platforms and the LS skills that are targeted.
Methods
A scoping review was conducted between January 1997 and October 2018 for full-text articles. The search was done in various databases. Only articles written in English or French were included. Additional studies were identified through reference lists. The search terms included “laparoscopic suturing” and “clinical competence.”
Results
Sixty-two studies were selected. The majority of the simulation platforms were box trainers with inanimate tissue, and targeted basic suturing and intracorporeal knot-tying techniques. Most of the validation came from internal structure (rater reliability) and relationship to other variables (compare training levels/case experience, and various metrics). Consequences were not addressed in any of the studies.
Conclusion
We identified many types of simulation platforms that were used for assessing LS skills, with most being for assessment of basic skills. Platforms assessing the competence of trainees for advanced LS skills were limited. Therefore, future research should focus on development of LS tasks that better reflect the needs of the trainees.
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Acknowledgements
We would like to thank the members of the Henry K.M. DeKuyper Education Centre, Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, and Steinberg Centre for Simulation and Interactive Learning for their help in conducting this study.
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There was no funding or financial support for this work.
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Disclosures
The Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation received an unrestricted educational grant from Medtronic Canada. Elif Bilgic, Motaz Alyafi, Tomonori Hada, Tara Landry, Gerald M Fried, and Melina C Vassiliou have no relevant conflicts of interest or financial ties to disclose.
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Appendix 1: Medline search strategy
Appendix 1: Medline search strategy
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1.
Exp Laparoscopy/ (90382)
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2.
Suture Techniques/ (43044)
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3.
Sutures/ (16421)
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4.
2 or 3 (54604)
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5.
1 and 4 (2898)
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6.
((Extracorporeal or extra-corporeal or intracorporeal or intra-corporeal or laparo*) adj3 (sutur* or knot*)).tw,kf. (2117)
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7.
5 or 6 (4242)
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8.
ed.fs. (261740)
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9.
Education, medical, graduate/ (26742)
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10.
“Internship and residency”/ (44310)
-
11.
Exp Teaching/ (80605)
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12.
Exp Learning/ (362731)
-
13.
(Curricul* or educat* or instruct* or learn* or teach* or train* or tuition).tw,kf. (1305770)
-
14.
or/8-13 (1650389)
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15.
7 and 14 (747)
-
16.
Limit 15 to English (696)
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17.
Remove duplicates from 16 (653)
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18.
Limit 17 to yr=”2000 Current” (607)
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Bilgic, E., Alyafi, M., Hada, T. et al. Simulation platforms to assess laparoscopic suturing skills: a scoping review. Surg Endosc 33, 2742–2762 (2019). https://doi.org/10.1007/s00464-019-06821-y
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DOI: https://doi.org/10.1007/s00464-019-06821-y