title: Preoperative simulation regarding the appropriate port location for laparoscopic hepaticojejunostomy: a randomized study using a disease-specific training simulator.
abstract: OBJECTIVE
  We verified the appropriate port location for laparoscopic hepaticojejunostomy using a comprehensive laparoscopic training simulator.
  
  
  METHODS
  We developed a hepaticojejunostomy model, consist of common hepatic duct and intestine and participants required to place two sutures precisely using two different port locations (A: standard port location, B: modified port location). The order of tasks was randomly determined using the permuted block method (Group I: Task A → Task B, Group II: Task B → Task A). The time for task completion and total number of errors were recorded. In addition, we evaluated the spatial paths and velocity of both forceps. Statistical analyses were performed using a statistical software program.
  
  
  RESULTS
  The time for the task, the total error score, and the spatial paths and velocity of both forceps were not significantly different between groups I and II. Furthermore, the port location and order of tasks (group I or group II) did not significantly affect the results. In contrast, there were significant differences in the performance between experts and novices, who were classified as such based on the total number of experienced endoscopic surgeries.
  
  
  CONCLUSIONS
  Preoperative port simulation in advanced surgery using our artificial simulator is feasible and may facilitate minimally invasive surgery for children.
authors: Department of Pediatric Surgery, Reproductive and Development Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, Fukuoka, 812-8582, Japan.|Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors: Takahiro
authors: T
authors: Jimbo
authors: Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan.
authors: Satoshi
authors: S
authors: Ieiri
authors: Department of Pediatric Surgery, Reproductive and Development Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, Fukuoka, 812-8582, 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, 3-1-1, Maidashi, Higashi-ku, Fukuoka, Fukuoka, 812-8582, 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, 3-1-1, Maidashi, Higashi-ku, Fukuoka, Fukuoka, 812-8582, Japan. taguchi@pedsurg.med.kyushu-u.ac.jp.
authors: Tomoaki
authors: T
authors: Taguchi
mesh_terms: D002983:Clinical Competence; D006801:Humans; D007564:Japan; D007582:Jejunostomy / Q000193:education / Q000379:methods*; D010535:Laparoscopy / Q000193:education / Q000379:methods*; D008099:Liver / Q000601:surgery*; D008348:Manikins; D011897:Random Allocation
keywords: Laparoscopic hepaticojejunostomy; Laparoscopic surgery; Objective skill validation system; Surgical training; Video-based evaluation