Laparoscopic performance after one night on call in a surgical department: prospective study
BMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7323.1222 (Published 24 November 2001) Cite this as: BMJ 2001;323:1222
Data supplement
Performance of simulated laparoscopic tasks by surgeons before and after a night on call.* Values are medians (ranges)
Measurement Task 1 Task 2 Task 3 Task 4 Task 5 Task 6 Before After P value Before After P value Before After P value Before After P value Before After P value Before After P value Time taken to complete the task (s) 5.4 (4.1-9.3)
7.6 (5-20.3)
0.006 7.2 (5-14)
9.1 (5.4-14.5)
0.25 5.6 (3.7-11.1)
7.8 (4-21.1)
0.004 6.7 (4.8-11.7)
8.1 (5.8-14)
0.003 15.0 (12.3-18.4)
18.1 (13.6-22.8)
0.003 18.2 (13.1-21.7)
23.8 (16.3-30.4)
0.002 No of errors made 0.6 (0-2.5)
1.0 (0-5.5)
0.013 0.4 (0-2)
0.5 (0-5.3)
0.44 2.3 (0-4.8)
2.5 (0-6.8)
0.35 0.3 (0-2.3)
0.5 (0-3.3)
0.72 0.9 (0-3)
1.4 (0-7.3)
0.061 1.4 (0.3-5.3)
3.5 (0.3-11.5)
0.005 No of unnecessary movements made 4.3 (3.4-5.5)
5.2 (3.3-13)
0.56 4.6 (3.4-8.7)
4.4 (3.6-8.3)
0.78 5.4 (3.8-7.7)
6.5 (3.3-13.7)
0.27 3.6 (2.7-4.9)
3.6 (2.9-4.3)
0.93 7.8 (4.1-10.4)
9.4 (5.1-22.1)
0.008 6.1 (4-8.2)
8.2 (4.3-16.4)
0.004 *The six tasks are of progressive complexity and are designed to simulate the techniques used in performing laparoscopic cholecystectomy. All tasks begin with bilateral movements to touch a virtual sphere with the tips of the virtual instruments.
For task 1 the trainee is required to grasp a virtual sphere and place it in a virtual box. As with all tasks this is repeated twice for each hand.
In task 2 the virtual sphere is grasped, transferred between instruments and then placed in the box.
Task 3 consists of grasping alternately the segments of a virtual pipe.
Task 4 requires the trainee to grasp the virtual sphere, touch it with the tip of the other instrument, withdraw and reinsert this instrument and once more touch the sphere.
In task 5, once the virtual sphere has been grasped, three plates appear on the surface of the sphere, 90° apart; these are then touched by the other instrument and, using the pedal, virtually diathermied away.
Task 6 combines the actions of tasks four and five with the aim of diathermying the plates while holding the sphere in the virtual box.
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