Validation of a simulation-training model for robotic intracorporeal bowel anastomosis using a step-by-step technique Journal Article


Authors: von Rundstedt, F. C.; Aghazadeh, M. A.; Scovell, J.; Slawin, J.; Armstrong, J.; Silay, S.; Goh, A. C.
Article Title: Validation of a simulation-training model for robotic intracorporeal bowel anastomosis using a step-by-step technique
Abstract: Objective: To develop and validate a training model for the robotic intracorporeal bowel anastomosis. Methods: For simulation, surgeons with varying levels of experience were instructed about bowel anastomosis robotic surgical simulation in a short educational video. All participants performed the required steps for the intracorporeal bowel anastomosis under standardized conditions. The procedure consists of the following steps: division of the bowel with a stapler (1), incision and opening of the bowel limbs at the antimesenteric angle (2), insertion of the stapler into the 2 bowel limbs for the side-to-side anastomosis (3), and transverse closure of the anastomosis with the stapler (4). All simulations were performed using the daVinci SI robotic system. Face and content validity were assessed using a standardized questionnaire. Construct validity was evaluated using the Global Evaluative Assessment of Robotic Skills, a validated global performance rating scale. Results: Twenty-two surgeons participated including 6 robotic experts and 16 trainees. The expert participants rated the bowel anastomosis model highly for face validity (median 4/5; 64% agree or strongly agree), and all participants rated the content as a training model very highly (median 4.5/5; 100% agree or strongly agree). Discrimination between experts and trainees using Global Evaluative Assessment of Robotic Skills demonstrated construct validity (novice 17.6 vs expert 24.7, P =.03). Conclusion: We demonstrate that the bowel anastomosis robotic surgical simulator is a reproducible and realistic simulation that allows for an objective skills assessment. We establish face, content, and construct validity for this model. This step-by-step technique may be utilized in training surgeons desiring to acquire skills in robotic intracorporeal urinary diversion. © 2018
Keywords: controlled study; reproducibility; cohort analysis; validation study; cost effectiveness analysis; questionnaire; surgeon; cystectomy; scoring system; medical specialist; construct validity; content validity; reliability; clinical effectiveness; face validity; intestine anastomosis; incision; human; priority journal; article; robotic surgical procedure; simulation training; global evaluative assessment of robotic skills score; interobserver reliability; robotic intracorporeal bowel anastomosis; side to side anastomosis
Journal Title: Urology
Volume: 120
ISSN: 0090-4295
Publisher: Elsevier Science, Inc.  
Date Published: 2018-10-01
Start Page: 125
End Page: 130
Language: English
DOI: 10.1016/j.urology.2018.07.035
PUBMED: 30092304
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 3 December 2018 -- Source: Scopus
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  1. Alvin Chun chin Goh
    5 Goh