title: Rigid vs articulating instrumentation for task completion in single-port surgery.
abstract: BACKGROUND
  Single-port access surgery (SPA) may provide benefits but there is a steep learning curve. We compare traditional in-line instruments with articulating instruments.
  
  
  METHODS
  Fundamentals of laparoscopic surgery peg transfer task was performed using a 3-port approach or SPA device. Standard rigid instrumentation was compared with articulating instrumentation.
  
  
  RESULTS
  Twenty surgeons completed all tasks. Average time using a conventional approach was shorter than SPA (144 ± 54 vs 198 ± 74 seconds, P < .001). Articulating instruments required longer procedural time than rigid instrumentation (201 ± 66 vs 141 ± 58 seconds, P < .001). In the conventional model, task time was lower with rigid instruments than with articulating instruments (108 vs 179 seconds, P < .001). Task time in the SPA model was lower with rigid instruments (173 vs 223 seconds, P =.013).
  
  
  CONCLUSIONS
  All tasks required longer time to complete in SPA when compared with a conventional approach. Articulating instruments have an increased benefit in SPA surgery.
authors.affiliation: Department of Surgery, Division of General Surgery, University of British Columbia, 2775 Laurel Street, Vancouver, British Columbia, V5Z 1M9, Canada.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Chow
authors.affiliation: Department of Surgery, Division of General Surgery, University of British Columbia, 2775 Laurel Street, Vancouver, British Columbia, V5Z 1M9, Canada.
authors.forename: Chieh Jack
authors.initials: CJ
authors.lastname: Chiu
authors.affiliation: Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Bin
authors.initials: B
authors.lastname: Zheng
authors.affiliation: Department of Surgery, Division of General Surgery, University of British Columbia, 2775 Laurel Street, Vancouver, British Columbia, V5Z 1M9, Canada.
authors.forename: Ormond Neely
authors.initials: ON
authors.lastname: Panton
authors.affiliation: Department of Surgery, Division of General Surgery, University of British Columbia, 2775 Laurel Street, Vancouver, British Columbia, V5Z 1M9, Canada. Electronic address: adam.meneghetti@vch.ca.
authors.forename: Adam T
authors.initials: AT
authors.lastname: Meneghetti
mesh_terms: D001955:British Columbia; D003198:Computer Simulation; D004867:Equipment Design; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000193:education / Q000295:instrumentation*; D059032:Learning Curve; D066231:Surgeons / Q000193:education*; D013647:Task Performance and Analysis
keywords: Articulating instrumentation; Performance assessment; Simulation; Single-port access surgery; Surgical education