Validation of a pediatric single-port laparoscopic surgery simulator.
BACKGROUND
This study aims to adapt an existing multiport pediatric laparoscopic surgery simulator to be suitable for pediatric single-port laparoscopy and to investigate construct validity for its use as a resource for skills training and assessment.


METHODS
An existing pediatric-sized box trainer was modified to accommodate a commercially available port. A total of 41 participants (18 novices, 16 intermediates and 7 experts) were recruited to complete four curriculum tasks via a single-port access approach. Objective task performance scores were evaluated.


RESULTS
Task completion times and performance scores were significantly different between novices and experts for the peg transfer (P = 0.02, P = 0.008 respectively), pattern cut (P < 0.001, P < 0.001 respectively) and ligating loop (P = 0.038, P = 0.035 respectively). There were significant differences in outcomes between novices and intermediates for all tasks, including the intracorporeal suture task (P ≤ 0.001). There were no significant differences in outcomes between intermediates and experts for all tasks.


CONCLUSIONS
The Pediatric Laparoscopic Surgery (PLS) simulator can be easily adapted for single-port laparoscopic surgery to be construct valid for the peg transfer, ligating loop and pattern cut tasks. There is scope for additional tasks to be developed that focus on the unique technical challenges and skills associated with single-port techniques.
The Hamlyn Centre, Institute of Global Health Innovation, Imperial College London, UK.
Geraint L
GL
Herbert
The Hamlyn Centre, Institute of Global Health Innovation, Imperial College London, UK. Electronic address: t.cundy@imperial.ac.uk.
Thomas P
TP
Cundy
The Hamlyn Centre, Institute of Global Health Innovation, Imperial College London, UK.
Pritam
P
Singh
Department of Paediatric Surgery, Chelsea and Westminster Hospital, London, UK.
Giuseppe
G
Retrosi
The Hamlyn Centre, Institute of Global Health Innovation, Imperial College London, UK.
Mikael H
MH
Sodergren
Hospital for Sick Children, University of Toronto, Ontario, Canada.
Georges
G
Azzie
The Hamlyn Centre, Institute of Global Health Innovation, Imperial College London, UK.
Ara
A
Darzi
D000328:Adult; D002983:Clinical Competence; D003198:Computer Simulation; D003479:Curriculum; D006801:Humans; D010535:Laparoscopy / Q000193:education* / Q000379:methods; D010372:Pediatrics / Q000193:education*; D013647:Task Performance and Analysis; D055815:Young Adult
Education; Laparoscopy; Pediatric; Simulation; Single port; Training