Educational application of intraoperative records from an energy device in laparoscopic gastrectomy: a preliminary repor
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ORIGINAL ARTICLE
Educational application of intraoperative records from an energy device in laparoscopic gastrectomy: a preliminary report Hisahiro Hosogi1,4 · Kazutaka Obama2 · Shigeru Tsunoda2 · Shigeo Hisamori2 · Tatsuto Nishigori2 · Eiji Tanaka3 · Seiji Satoh4 · Hiroshi Okabe5,6 · Seiichiro Kanaya1 · Yoshiharu Sakai1,2 Received: 20 July 2020 / Accepted: 15 September 2020 © Springer Nature Singapore Pte Ltd. 2020
Abstract Purpose Video review is a reliable method for surgical education in laparoscopic gastrectomy (LG), but more objective methods are still needed. The purpose of this study was to determine whether the energy device records reflected surgical competency, and thereby may improve surgical education. Methods A total of 16 patients who underwent LG for gastric cancer using the Thunderbeat® device were preliminarily retrospectively analyzed. This device has the function of ‘intelligent tissue monitoring’ (ITM), a safety assist system stopping energy output, and can record ITM detections and firing time during surgery. The number of ITM detections and firings, and the total firing time during gastrocolic ligament dissection and infrapyloric dissection were compared between trainees (n = 9 by 5 surgeons) and experts (n = 7 by 5 surgeons). The non-edited videos (n = 16) were scored, and the correlations between the scores and the records were then analyzed. Results Significantly more ITM detections, firings, and a longer total firing time were observed in trainees than in experts. The number of ITM detections and firing had negative correlations with the scores of the operation speed, the use of the non-dominant hand, and the use of an energy device. Conclusions Our preliminary study suggested that the above described energy device records reflected surgical competency, and thereby may improve surgical education. Keywords Thunderbeat · Education · Laparoscopic gastrectomy
Introduction Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00595-020-02160-x) contains supplementary material, which is available to authorized users. * Kazutaka Obama [email protected]‑u.ac.jp 1
Department of Surgery, Japanese Red Cross Osaka Hospital, Osaka, Japan
2
Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara‑cho, Shogoin, Sakyo‑ku, Kyoto 606‑8507, Japan
3
Department of Surgery, Tazuke Kofukai Medical Research Institute Kitano Hospital, Osaka, Japan
4
Department of Surgery, Kyoto City Hospital, Kyoto, Japan
5
Department of Surgery, Otsu Municipal Hospital, Otsu, Japan
6
Department of Gastroenterological Surgery, New Tokyo Hospital, Matsudo, Japan
Gaining surgical competence is a complex, multifactorial process that may take years of experience and on-the-job training. Superior technical performance in surgery has been demonstrated to positively affect patient outcomes [1], including laparoscopic gastrectomy (LG) for gastric cancer [2]. For efficient surgical education and training, video review [3, 4], or training
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