title: A cadaveric porcine model for assessment in laparoscopic bariatric surgery--a validation study.
abstract: BACKGROUND
  Laparoscopic Roux-en-Y gastric bypass (LRYGBP) is the most effective surgical therapy for morbid obesity. It is an advanced laparoscopic surgical procedure and has a protracted learning curve. Therefore, it is important to develop innovative ways of training and assessing surgeons. The aim of this study is to determine if a cadaveric porcine jejuno-jejunostomy model is an accurate way of assessing a surgeon's technical skills by determining if a correlation exists with how he performs in the operating room.
  
  
  METHODS
  Eight surgeons of varying experience performed a side-to-side stapled jejuno-jejunostomy on a cadaveric bench model before proceeding to perform the procedure on a real patient scheduled for LRYGBP. Performance was assessed using a motion tracking device, the Imperial College Surgical Assessment Device. Each procedure was recorded in video and scored by two blinded expert surgeons using procedure-specific rating scales.
  
  
  RESULTS
  The cadaveric bench model demonstrated concurrent validity with significant correlations between performance on the cadaveric model and patient for dexterity measures. Left-hand path length, r = 0.857 (median, 27, 41.3; P = 0.007), right-hand path length, r = 0.810 (median, 31.5, 60; P = 0.015) and total number of movements, r = 0.743 (median, 422, 637; P = 0.035). This correlation in performance was also demonstrated in the video rating scales, r = 0.727 (median, 13.2, 14.8; P = 0.041). No correlation was found in operative time (median, 541, 742; P = 0.071).
  
  
  CONCLUSIONS
  This study demonstrates the concurrent validity of the cadaveric porcine model, showing similar performances in surgeons completing a jejuno-jejunostomy on the cadaveric model and the patient.
authors: Department of Digestive Surgery, Hospital Clinico, Pontificia Universidad Católica de Chile, Marcoleta 352, Santiago, Chile. bozauc@med.puc.cl
authors: Camilo
authors: C
authors: Boza
authors: Julian
authors: J
authors: Varas
authors: Erwin
authors: E
authors: Buckel
authors: Pablo
authors: P
authors: Achurra
authors: Nicolás
authors: N
authors: Devaud
authors: Trystan
authors: T
authors: Lewis
authors: Rajesh
authors: R
authors: Aggarwal
mesh_terms: D000818:Animals; D002983:Clinical Competence; D005257:Fellowships and Scholarships; D015390:Gastric Bypass / Q000193:education* / Q000379:methods; D013502:General Surgery / Q000193:education; D007396:Internship and Residency; D007582:Jejunostomy / Q000193:education* / Q000379:methods; D010535:Laparoscopy / Q000193:education* / Q000379:methods; D023421:Models, Animal; D013552:Swine; D013647:Task Performance and Analysis
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