90th Annual Meeting Abstracts
Development of Neonatal Minimally Invasive Surgery Trainers
*Karen A. Diefenbach, M.D., R. Lawrence Moss, M.D., *Milissa A. McKee, M.D.
Yale School of Medicine, New Haven, CT
Objective: The objective of this study was to develop minimally invasive surgery trainers scaled to neonatal patients and to evaluate construct validity of these trainers.
Setting: Yale School of Medicine, Department of Surgery.
Participants: A volunteer sample of surgical residents, fellows, and faculty.
Interventions: After verification that this study was exempt from approval of the Human Investigation Committee, infants weighing between 2.5kg and 3.5 kg were measured to record 17 different data points and average values were obtained. Using this data, scaled surgical trainers for laparoscopic and thoracoscopic surgery in neonates were developed. Volunteer participants of varying skill level and surgical experience performed prescribed tasks. Laparoscopic trainers were used for dexterity skills, running the bowel, and intracorporeal suturing and knot-tying. Suturing and knot-tying under tension were performed in a thoracoscopic trainer designed to represent a congenital diaphragmatic hernia model.
Main Outcome Measures: Time to completion of tasks, number of errors in performing tasks.
Results:
| | Novice | Experienced | Expert |
| Completion Time
Ave (range) | Errors
Ave/task | Completion Time
Ave (range) | Errors
Ave/task | Completion Time
Ave (range) | Errors
Ave/task |
| Dexterity Skills | 4min 55sec
(2:41-3:41) | 1.3 | 4 min 30 sec
(3:31-5:29) | 1 | 3min 04sec
(2:02-4:29) | 1.6 |
| Running the Bowel | 5min 57sec
(3:20-10:20) | 0 | 3min 47sec
(2:50-4:43) | 0 | 2min 26sec
(2:05-2:55) | 0 |
| Intracorporeal Suturing/Knot | 5min 57sec
(2:54-12:27) | 2.7 | 4min 03sec
(2:10-6:21) | 2.5 | 1min 57sec
(1:05-3:28) | 1 |
Thoracoscopic
Suturing/Knot* | | | | | 4min 18sec
(2:17-7:55) | 0 |
* Participants with advanced training
Conclusions:Neonatal MIS trainers can be developed as simple models for both standard and complex tasks. Experienced participants performed better in both time to completion and accuracy of completion of assigned tasks. This verifies the construct validity of the trainers with actual performance in the different testing groups confirming expected performance.
