Correlation between operative time and crowd-sourced skills assessment for robotic bariatric surgery
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and Other Interventional Techniques
2020 SAGES ORAL
Correlation between operative time and crowd‑sourced skills assessment for robotic bariatric surgery Poppy Addison1 · Andrew Yoo2 · Jacqueline Duarte‑Ramos3 · Jermyn Addy1 · Samuel Dechario4 · Gregg Husk5 · Mark Jarrett5 · Julio Teixeira1,6 · Anthony Antonacci5 · Filippo Filicori1,6 Received: 13 May 2020 / Accepted: 16 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Introduction Operative time has been traditionally used as a proxy for surgical skill and is commonly utilized to measure the learning curve, assuming that faster operations indicate a more skilled surgeon. The Global Evaluative Assessment of Robotic Skills (GEARS) rubric is a validated Likert scale for evaluating technical skill. We hypothesize that operative time will not correlate with the GEARS score. Methods Patients undergoing elective robotic sleeve gastrectomy at a single bariatric center of excellence hospital from January 2019 to March 2020 were captured in a prospectively maintained database. For step-specific scoring, videos were broken down into three steps: ligation of short gastric vessels, gastric transection, and oversewing the staple line. Overall and step-specific GEARS scores were assigned by crowd-sourced evaluators. Correlation between operative time and GEARS score was assessed with linear regression and calculation of the R2 statistic. Results Sixty-eight patients were included in the study, with a mean operative time of 112 ± 27.4 min. The mean GEARS score was 20.1 ± 0.81. Mean scores for the GEARS subcomponents were: bimanual dexterity 4.06 ± 0.17; depth perception 3.96 ± 0.24; efficiency 3.82 ± 0.19; force sensitivity 4.06 ± 0.20; robotic control 4.16 ± 0.21. Operative time and overall score showed no correlation (R2 = 0.0146, p = 0.326). Step-specific times and scores showed weak correlation for gastric transection (R2 = 0.0737, p = 0.028) and no correlation for ligation of short gastric vessels (R2 = 0.0262, p = 0.209) or oversewing the staple line (R2 = 0.0142, p = 0.344). Conclusions Operative time and crowd-sourced GEARS score were not correlated. Operative time and GEARS scores measure different performance characteristics, and future studies should consider using both a validated skills assessment tool and operative time for a more complete evaluation of skill. Keywords Skill assessment · Operative time · Surgical education
* Poppy Addison [email protected] 1
Department of General Surgery, Lenox Hill Hospital, Northwell Health, 186 E 76th St, 1st Floor, New York, NY 10075, USA
2
C-SATS, Inc., Seattle, WA, USA
3
Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA
4
Institute for Spine and Scoliosis, Lawrenceville, NJ, USA
5
Northwell Health, Manhasset, NY, USA
6
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
Given the rise in robotic surgery, increasing attention has been paid to the acquisition of these novel surgical skill
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