title: Performance of simulated laparoscopic incisional hernia repair correlates with operating room performance.
abstract: BACKGROUND
  the role of simulation for training in procedures such as laparoscopic incisional hernia repair (LIHR) is unknown. The purpose of this study was to determine whether performance in simulated LIHR correlates with operating room (OR) performance.
  
  
  METHODS
  subjects performed LIHR in the University of Maryland Surgical Abdominal Wall (SAW) simulator and the OR. Trained observers used a LIHR-specific global rating scale (Global Operative Assessment of Laparoscopic Skills-Incisional Hernia) to assess performance. Global Operative Assessment of Laparoscopic Skills-Incisional Hernia includes 7 domains (trocar placement, adhesiolysis, mesh sizing, mesh positioning, mesh fixation, knowledge and autonomy in instrument use, and overall competence). The correlation between simulator and OR performance was assessed using the Pearson coefficient.
  
  
  RESULTS
  fourteen surgeons from 2 surgical departments participated. Experienced surgeons (n = 9) were defined as attending surgeons and minimally invasive surgury (MIS) fellows, and novice surgeons (n = 5) were general surgery residents (postgraduate years 3-5). The correlation between performance in the OR and the simulator for the entire group was .87 (95% confidence interval, .63-.96; P < .001).
  
  
  CONCLUSIONS
  there was an excellent correlation between LIHR performance in the simulator and clinical LIHR. This suggests that performance in the SAW simulator may predict performance in the operating room.
authors.affiliation: Steinberg-Bernstein Centre for Minimally Invasive Surgery, McGill University Health Centre, 1650 Cedar Ave., Montreal, Quebec, Canada.
authors.forename: Iman
authors.initials: I
authors.lastname: Ghaderi
authors.forename: Marilou
authors.initials: M
authors.lastname: Vaillancourt
authors.forename: Gideon
authors.initials: G
authors.lastname: Sroka
authors.forename: Pepa A
authors.initials: PA
authors.lastname: Kaneva
authors.forename: F Jacob
authors.initials: FJ
authors.lastname: Seagull
authors.forename: Ivan
authors.initials: I
authors.lastname: George
authors.forename: Erica
authors.initials: E
authors.lastname: Sutton
authors.forename: Adrian E
authors.initials: AE
authors.lastname: Park
authors.forename: Melina C
authors.initials: MC
authors.lastname: Vassiliou
authors.forename: Gerald M
authors.initials: GM
authors.lastname: Fried
authors.forename: Liane S
authors.initials: LS
authors.lastname: Feldman
mesh_terms: D006555:Hernia, Ventral / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008953:Models, Anatomic; D009048:Motor Skills; D013526:Surgical Mesh