Quality-based assessment of laparoscopic camera navigation for resident surgeons - A randomised control study.

Abstract

Introduction: The introduction of laparoscopy has revolutionised the field of surgery. Camera navigation is a pivotal factor for a successful laparoscopic surgery. Good camera assistance guides the operating surgeon towards a safe and successful surgery. Laparoscopic camera navigation is a complicated task, requiring specific psychomotor and visuospatial skills. This study aimed to find out whether the objective structured assessment of camera navigation skills (OSA-CNS) is an effective tool for assessment and feedback to the residents.

Patients and methods: This was a single-centre randomised study with a test group and a control group having surgical residents as participants. The sample size is 24, with 12 in each group. Residents were assessed based on the five key parameters of camera navigation skills by an expert surgeon and the operating surgeon. The test and control group scores were analysed along with the progress of the groups after each assessment. Each participant assisted in five laparoscopic cholecystectomies. Statistical tests were conducted using SSPN and R-code.

Results: After the assessment, the test group had improved scores compared to the control group, which was statistically significant (P < 0.001). The analysis of variance test of the groups revealed that the test group participant scores improved after each assessment (F = 23.45, P < 0.001). The residents opined that the objective assessment helped improve their navigation skills.

Conclusion: The data from our study showed that the OSA-CNS is a viable and reliable tool. This structured assessment helps to improve camera navigation and has great scope in the future with regard to surgical training.