Comparison of the performance of experienced and novice surgeons: measurement of gripping force during laparoscopic surgery performed on pigs using forceps with pressure sensors

Surg Endosc. 2017 Apr;31(4):1999-2005. doi: 10.1007/s00464-016-5153-x. Epub 2016 Aug 29.

Abstract

Background: Laparoscopic surgical techniques are difficult to learn, and developing such skills involves a steep learning curve. To ensure surgeons achieve a high skill level, it is important to be able to measure and assess their skills. Therefore, it is necessary to understand the performance differences between experienced and novice surgeons, as such information could be used to help surgeons learn laparoscopic skills. We examined the differences in gripping and reaction force between experienced and novice surgeons during laparoscopic surgery.

Methods: We measured the gripping force generated during laparoscopic surgery performed on pigs using forceps with pressure sensors. Several sensors, including strain gauges, accelerometers, and a potentiometer, were attached to the forceps. This study included 4 experienced and 4 novice surgeons. Each subject was asked to elevate the kidney in order to approach the renal hilus using the forceps. Throughout the experiment, we measured the gripping force and reaction force generated during the movement of the forceps in real time.

Results: The experienced and novice surgeons exhibited similar reaction force levels. Conversely, gripping force differed significantly between the groups. The experienced and novice surgeons exhibited mean gripping force levels of 3.06 and 7.15 N, respectively. The gripping force standard deviation values for the experienced and novice surgeons were 1.43 and 3.54 N, respectively. The mean and standard deviation gripping force values of the experienced surgeons were significantly lower than those of the novice surgeons (P = 0.015 and P = 0.011, respectively).

Conclusions: This study indicated that experienced surgeons generate weaker but more stable gripping force than novice surgeons during laparoscopic procedures.

Keywords: Force measurement system; Gripping force; Laparoscopy.

Publication types

  • Comparative Study

MeSH terms

  • Animals
  • Biomechanical Phenomena
  • Clinical Competence*
  • Hand Strength*
  • Internship and Residency
  • Laparoscopy / standards*
  • Mechanical Phenomena
  • Surgical Instruments*
  • Sus scrofa
  • Swine
  • Urologists*
  • Urology / education