Surgical Skill Analysis Based on the Way of Grasping Organs with Forceps in Dissection Procedure of Laparoscopic Surgery

Abstract

This paper presents a surgical skill analysis based on the way of grasping organs with forceps in dissection procedure in a wet lab training for laparoscopic surgery. Forty-four medical doctors and students conducted lymphadenectomy training using laparoscopic surgical instruments and porcine cadaver organs. During the training, movement of surgical instrument, grasping frequency/force/position, path length, completion time and other indices were measured. Among the indices, this paper focuses on analyzing the relationship between surgical skill level and the way of grasping organs with forceps such as grasping frequency, force, and position. The subjects are classified into three groups (novice, intermediate and expert) by the number of experienced surgeries. The indices between the three groups are compared by the Kruskal–Wallis and Mann–Whitney U test. The results of analysis show that the ratio of non-grasping period to the total task time of novice surgeons is larger than that of experts, and the total number of grasping of novices is greater than that of experts. From the results, it is found that the novices frequently re-grasp organs during the dissection operation. There is a possibility that novices frequently fail to grasp the organ at an optimal point and hence repeat re-grasping.