title: Development of an objective endoscopic surgical skill assessment system for pediatric surgeons: suture ligature model of the crura of the diaphragm in infant fundoplication.
abstract: OBJECTIVE
  The Japanese Society of Pediatric Endoscopic Surgeons developed an endoscopic surgical skill qualification (ESSQ) system. However, this is a subjective system we developed and validated an objective skill evaluation system for pediatric surgeons.
  
  
  METHODS
  In the ESSQ system, the task operation is laparoscopic fundoplication. Therefore, we set up a suture ligature model of the crura of the diaphragm for infant fundoplication. Examinees were divided into 2 groups, 10 experts and 16 trainees. They had to perform two suture ligatures of the crura using an intracorporeal knot in the box. Evaluation points were time, force on the tissue, suture tension, stitch spacing, equidistance, mean score, and total score. Statistical analysis was performed and p < 0.05 was considered statistically significant.
  
  
  RESULTS
  Experts showed better score than trainees in the time score (p < 0.0001), the score for force on the tissue (p < 0.0001), the stitch spacing score (p < 0.05), the equidistance score (p < 0.005), the mean score (p < 0.0001), and the total score (p < 0.0005), respectively.
  
  
  CONCLUSIONS
  The results revealed that the expert group possessed gentle and speedy skills compared with that of the novices. Using this validation study, our established model could be used to objectively evaluate the endoscopic surgical skills of pediatric surgeons.
authors: Department of Pediatric Surgery, Reproductive and Developmental Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. satoshi@med.kyushu-u.ac.jp
authors: Satoshi
authors: S
authors: Ieiri
authors: Hiroyuki
authors: H
authors: Ishii
authors: Ryota
authors: R
authors: Souzaki
authors: Munenori
authors: M
authors: Uemura
authors: Morimasa
authors: M
authors: Tomikawa
authors: Noriyuki
authors: N
authors: Matsuoka
authors: Atsuo
authors: A
authors: Takanishi
authors: Makoto
authors: M
authors: Hashizume
authors: Tomoaki
authors: T
authors: Taguchi
mesh_terms: D057189:Checklist; D002983:Clinical Competence; D003964:Diaphragm / Q000601:surgery*; D018662:Fundoplication / Q000379:methods; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007223:Infant; D010535:Laparoscopy; D013536:Suture Techniques
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