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Laparoscopic skill assessment of practicing surgeons prior to enrollment in a surgical trial of a new laparoscopic procedure.

Publication ,  Journal Article
Zendejas, B; Jakub, JW; Terando, AM; Sarnaik, A; Ariyan, CE; Faries, MB; Zani, S; Neuman, HB; Wasif, N; Farma, JM; Averbook, BJ; Bilimoria, KY ...
Published in: Surg Endosc
August 2017

BACKGROUND: Outcomes of surgical trials hinge on surgeon selection and their underlying expertise. Assessment of expertise is paramount. We investigated whether surgeons' performance measured by the fundamentals of laparoscopic surgery (FLS) assessment program could predict their performance in a surgical trial. METHODS: As part of a prospective multi-institutional study of minimally invasive inguinal lymphadenectomy (MILND) for melanoma, surgical oncologists with no prior MILND experience underwent pre-trial FLS assessment. Surgeons completed MILND training, began enrolling patients, and submitted videos of each MILND case performed. Videos were scored with the global operative assessment of laparoscopic skills (GOALS) tool. Associations between baseline FLS scores and participant's trial performance metrics were assessed. RESULTS: Twelve surgeons enrolled patients; their median total baseline FLS score was 332 (range 275-380, max possible 500, passing >270). Participants enrolled 87 patients in the study (median 6 per surgeon, range 1-24), of which 72 (83%) videos were adequate for scoring. Baseline GOALS score was 17.1 (range 9.6-21.2, max possible score 30). Inter-rater reliability was excellent (ICC = 0.85). FLS scores correlated with improved GOALS scores (r = 0.57, p = 0.05) and with decreased operative time (r = -0.6, p = 0.02). No associations were found with the degree of patient recruitment (r = 0.02, p = 0.7), lymph node count (r = 0.01, p = 0.07), conversion rate (r = -0.06, p = 0.38) or major complications(r = -0.14, p = 0.6). CONCLUSIONS: FLS skill assessment of surgeons prior to their enrollment in a surgical trial is feasible. Although better FLS scores predicted improved operative performance and operative time, other trial outcome measures showed no difference. Our findings have implications for the documentation of laparoscopic expertise of surgeons in practice and may allow more appropriate selection of surgeons to participate in clinical trials.

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Published In

Surg Endosc

DOI

EISSN

1432-2218

Publication Date

August 2017

Volume

31

Issue

8

Start / End Page

3313 / 3319

Location

Germany

Related Subject Headings

  • Surgery
  • Reproducibility of Results
  • Prospective Studies
  • Program Evaluation
  • Postoperative Complications
  • Operative Time
  • Minimally Invasive Surgical Procedures
  • Melanoma
  • Male
  • Lymph Nodes
 

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Zendejas, B., Jakub, J. W., Terando, A. M., Sarnaik, A., Ariyan, C. E., Faries, M. B., … Farley, D. R. (2017). Laparoscopic skill assessment of practicing surgeons prior to enrollment in a surgical trial of a new laparoscopic procedure. Surg Endosc, 31(8), 3313–3319. https://doi.org/10.1007/s00464-016-5364-1
Zendejas, Benjamin, James W. Jakub, Alicia M. Terando, Amod Sarnaik, Charlotte E. Ariyan, Mark B. Faries, Sabino Zani, et al. “Laparoscopic skill assessment of practicing surgeons prior to enrollment in a surgical trial of a new laparoscopic procedure.Surg Endosc 31, no. 8 (August 2017): 3313–19. https://doi.org/10.1007/s00464-016-5364-1.
Zendejas B, Jakub JW, Terando AM, Sarnaik A, Ariyan CE, Faries MB, et al. Laparoscopic skill assessment of practicing surgeons prior to enrollment in a surgical trial of a new laparoscopic procedure. Surg Endosc. 2017 Aug;31(8):3313–9.
Zendejas, Benjamin, et al. “Laparoscopic skill assessment of practicing surgeons prior to enrollment in a surgical trial of a new laparoscopic procedure.Surg Endosc, vol. 31, no. 8, Aug. 2017, pp. 3313–19. Pubmed, doi:10.1007/s00464-016-5364-1.
Zendejas B, Jakub JW, Terando AM, Sarnaik A, Ariyan CE, Faries MB, Zani S, Neuman HB, Wasif N, Farma JM, Averbook BJ, Bilimoria KY, Tyler D, Brady MS, Farley DR. Laparoscopic skill assessment of practicing surgeons prior to enrollment in a surgical trial of a new laparoscopic procedure. Surg Endosc. 2017 Aug;31(8):3313–3319.
Journal cover image

Published In

Surg Endosc

DOI

EISSN

1432-2218

Publication Date

August 2017

Volume

31

Issue

8

Start / End Page

3313 / 3319

Location

Germany

Related Subject Headings

  • Surgery
  • Reproducibility of Results
  • Prospective Studies
  • Program Evaluation
  • Postoperative Complications
  • Operative Time
  • Minimally Invasive Surgical Procedures
  • Melanoma
  • Male
  • Lymph Nodes