title: A new innovative laparoscopic fundoplication training simulator with a surgical skill validation system.
abstract: We developed and validated a specific laparoscopic fundoplication simulator for use with the objective endoscopic surgical skills evaluation system. The aim of this study was to verify the quality of skills of surgeons.
  
  
  
  We developed a 1-year-old infant body model based on computed tomography data and reproduced pneumoperitoneum model based on the clinical situation. The examinees were divided into three groups: fifteen pediatric surgery experts (PSE), twenty-four pediatric surgery trainees (PSN), and ten general surgeons (GS). They each had to perform three sutures ligatures for construction of Nissen wrap. Evaluate points are time for task, the symmetry of the placement of the sutures, and the uniformity of the interval of suture ligatures in making wrap. And the total path length and velocity of forceps were measured to assess bi-hand coordination.
  
  
  
  PSE were significantly superior to PSN regarding total time spent (p < 0.01) and total path length (p < 0.01). GS used both forceps faster than the other groups, and PSN used the right forceps faster than the left forceps (p < 0.05). PSE were shorter with regard to the total path length than GS (p < 0.01). PSE showed most excellent results in the symmetry of the wrap among three groups.
  
  
  
  Our new model was used useful to validate the characteristics between GS and pediatric surgeon. Both PSE and GS have excellent bi-hand coordination and can manipulate both forceps equally and had superior skills compared to PSN. In addition, PSE performed most compact and accurate skills in the conflicted operative space.
authors: Department of Pediatric Surgery, Reproductive and Development Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.|Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors: Takahiro
authors: T
authors: Jimbo
authors: Department of Pediatric Surgery, Reproductive and Development Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan. satoshi@med.kyushu-u.ac.jp.|Department of Advanced Medicine and Innovative Technology, Kyushu University Hospital, Fukuoka, Japan. satoshi@med.kyushu-u.ac.jp.
authors: Satoshi
authors: S
authors: Ieiri
authors: Department of Pediatric Surgery, Reproductive and Development Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors: Satoshi
authors: S
authors: Obata
authors: Department of Advanced Medicine and Innovative Technology, Kyushu University Hospital, Fukuoka, Japan.
authors: Munenori
authors: M
authors: Uemura
authors: Department of Pediatric Surgery, Reproductive and Development Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.|Department of Advanced Medicine and Innovative Technology, Kyushu University Hospital, Fukuoka, Japan.
authors: Ryota
authors: R
authors: Souzaki
authors: Kyoto Kagaku Co., Ltd., Kyoto, Japan.
authors: Noriyuki
authors: N
authors: Matsuoka
authors: Kyoto Kagaku Co., Ltd., Kyoto, Japan.
authors: Tamotsu
authors: T
authors: Katayama
authors: Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors: Kouji
authors: K
authors: Masumoto
authors: Department of Advanced Medicine and Innovative Technology, Kyushu University Hospital, Fukuoka, Japan.
authors: Makoto
authors: M
authors: Hashizume
authors: Department of Pediatric Surgery, Reproductive and Development Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors: Tomoaki
authors: T
authors: Taguchi
mesh_terms: D002983:Clinical Competence; D018662:Fundoplication / Q000193:education* / Q000379:methods; D013502:General Surgery / Q000193:education; D006801:Humans; D007223:Infant; D007564:Japan; D010535:Laparoscopy / Q000193:education* / Q000379:methods; D010372:Pediatrics / Q000193:education; D000066908:Simulation Training / Q000379:methods*
keywords: Endoscopic surgery; Fundoplication; Objective skill assessment; Pediatric surgeon