Analysis and discussion of the research status of thoracoscopic and laparoscopicsimulation training and assessment_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHOU Jian , LIAO Hu , ZHENG Quan ,  LIU Lunxu

Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;

Corresponding?author：

LIU Lunxu, Email: lunxu_liu@aliyun.com

Keywords：

Simulation training; assessment; thoracoscopic and laparoscopic; Huaxi Intelligent Thoracoscopic Skill Training and Assessment System

DOI：

10.7507/1007-4848.202311033

Video：

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Abstract Full text Figures/Tables Video References Cited by

Minimally invasive surgery is the development direction of surgery in the 21st century, and thoracoscopic or laparoscopic skills are essential skills that all surgeons must master. Thoracoscopic or laparoscopic skills training is an important part of surgical resident training. However, there are various methods for thoracoscopic or laparoscopic skill training internationally. The assessment is still in the stage of examiners’ visual observation and subjective evaluation. Here, we reviewed the current research status of thoracoscopic and laparoscopic simulation training and assessment, discussed the development experience and application achievements of Huaxi Intelligent Thoracoscopic Skill Training and Assessment System. We aimed to provide a theoretical basis and practical experience for the development of thoracoscopic or laparoscopic simulation education.

Citation： ZHOU Jian, LIAO Hu, ZHENG Quan, LIU Lunxu. Analysis and discussion of the research status of thoracoscopic and laparoscopicsimulation training and assessment. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2024, 31(5): 667-671. doi: 10.7507/1007-4848.202311033 Copy

1.	St John A, Caturegli I, Kubicki NS, et al. The rise of minimally invasive surgery: 16 year analysis of the progressive replacement of open surgery with laparoscopy. JSLS, 2020, 24(4): e 2020.00076.
2.	鄭民華, 馬君俊, 吳超. 微創外科近20年進展及未來發展趨勢. 中國實用外科雜志, 2020, 40(1): 23-26, 32.
3.	廖虎, 梅建東, 劉成武, 等. 中國三級醫院胸外科學科臨床發展現狀的調查研究. 中華外科雜志, 2018, 56(12): 888-891.
4.	Cendan J, Wier D, Behrns K. A primer on standards setting as it applies to surgical education and credentialing. Sur Endoscopy, 2013, 27(7): 2631-2637.
5.	Bendixen M, Jorgensen OD, Kronborg C, et al. Postoperative pain and quality of life after lobectomy via video-assisted thoracoscopic surgery or anterolateral thoracotomy for early stage lung cancer: a randomised controlled trial. Lancet Oncol, 2016, 17(6): 836-844.
6.	Tang W, Zhang YF, Zhao YF, et al. Comparison of laparoscopic versus open radical antegrade modular pancreatosplenectomy for pancreatic cancer: A systematic review and meta-analysis. Int J Surg, 2022, 103: 106676.
7.	Wong KC, Lee KF, Lo EYJ, et al. Minimally invasive versus open liver resection for hepatocellular carcinoma: A propensity score matching analysis of 224 patients. Langenbecks Arch Surg, 2023, 408(1): 118.
8.	Munro M G. Surgical simulation: Where have we come from? Where are we now? Where are we going? J Minim Invasive Gynecol, 2012, 19(3): 272-283.
9.	Sullivan ME. Applying the science of learning to the teaching and learning of surgical skills: The basics of surgical education. J Surg Oncol, 2020, 122(1): 5-10.
10.	夏揚, 李衛民. 利用模擬醫院培養腔鏡醫生臨床技能的探索與實踐. 中國職業技術教育, 2013, 11: 84-86.
11.	Tarras SL, Thacker J, Bouwman DL, et al. Effective large group teaching for general surgery. Surg Clin North Am, 2021, 101(4): 565-576.
12.	Ferguson MK, Bennett C. Identification of essential components of thoracoscopic lobectomy and targets for simulation. Ann Thorac Surg, 2017, 103(4): 1322-1329.
13.	李永寧, 喻超, 李英, 等. 單中心腹腔鏡肝部分切除術學習曲線分析. 中華普外科手術學雜志(電子版), 2021, 15(4): 376-379.
14.	吳昊鈞, 汪大剛, 梁夢萍, 等. 結合術前三維重建的腹腔鏡肝切除術學習曲線研究. 肝膽胰外科雜志, 2022, 34(9): 537-542.
15.	Cypel M, Yasufuku K. Complications during minimal invasive thoracic surgery: Are new surgeons prepared? Lancet Oncol, 2018, 19(1): 17-19.
16.	Nashaat A, Sidhu HS, Yatham S, et al. Simulation training for lobectomy: A review of current literature and future directions. Eur J Cardiothorac Surg, 2019, 55(3): 386-394.
17.	Orejuela FJ, Aschkenazi SO, Howard DL, et al. Gynecologic surgical skill acquisition through simulation with outcomes at the time of surgery: A systematic review and meta-analysis. Am J Obstet Gynecol, 2022, 227(1): 29.e1-29.e4.
18.	Goldenberg MG, Garbens A, Szasz P, et al. Systematic review to establish absolute standards for technical performance in surgery. Br J Surg, 2017, 104(1): 13-21.
19.	張克勤, 李蜀婧, 畢罡. 內鏡與微創培訓在泌尿外科臨床教學中的應用. 局解手術學雜志, 2014, 23(3): 318-319.
20.	謝艷麗, 張冬雅, 韓麗萍. 宮腔鏡仿真模擬系統在婦科臨床培訓中的應用. 中國繼續醫學教育, 2022, 14(24): 113-117.
21.	王鳳蛟, 李雪鑫, 張磊, 等. 基于Lap Mentor的HACCP技術在住培醫生腔鏡培訓質控中的應用研究. 解放軍預防醫學雜志, 2020, 38(2): 75-77, 80.
22.	王春茂, 王雋, 韓鳴, 等. 虛擬仿真腔鏡模擬訓練器在胸外科住院醫師培訓中的應用探討. 中國醫刊, 2023, 58(8): 923-926.
23.	鄧建華, 吳海坤, 李薇, 等. 北京協和醫院基于SMART原則的泌尿外科專科腔鏡規范化培訓的經驗總結. 中國醫學科學院學報, 2023, 45(1): 88-91.
24.	胡孔旺, 陸明, 王宜文, 等. 三層次培訓在規培生腔鏡技能培訓中的應用研究. 中國高等醫學教育, 2017, 11: 9-10.
25.	李曉軍, 張佳, 張靖, 等. 胸外科住院醫師規范化培訓中胸腔鏡手術的培養與訓練. 臨床醫學研究與實踐, 2018, 3(8): 195-196.
26.	Vassiliou MC, Dunkin BJ, Marks JM, et al. FLS and FES: comprehensive models of training and assessment. Surg Clin North Am, 2010, 90(3): 535-558.
27.	Castellvi AO, Hollett LA, Minhajuddin A, et al. Maintaining proficiency after fundamentals of laparoscopic surgery training: A 1-year analysis of skill retention for surgery residents. Surg, 2009, 146(2): 387-93.
28.	Rooney DM, Santos BF, Hungness ES. Fundamentals of laparoscopic surgery (FLS) manual skills assessment: Surgeon vs nonsurgeon raters. J Surg Educ, 2012, 69(5): 588-592.
29.	Higgins RM, Turbati MS, Goldblatt MI. Preparing for and passing the fundamentals of laparoscopic surgery (FLS) exam improves general surgery resident operative performance and autonomy. Surg Endosc, 2023, 37(8): 6438-6444.
30.	Sansregret A, Fried GM, Hasson H, et al. Choosing the right physical laparoscopic simulator? Comparison of LTS2000-ISM60 with MISTELS: Validation, correlation, and user satisfaction. Am J Surg, 2009, 197(2): 258-65.
31.	Lazar A, Sroka G, Laufer S. Automatic assessment of performance in the FLS trainer using computer vision. Surg Endosc, 2023, 37(8): 6476-6482.
32.	Clark NV, Pepin KJ, Einarsson JI. Surgical skills assessment tools in gynecology. Curr Opin Obstet Gynecol, 2018, 30(5): 331-336.
33.	Campo R, Wattiez A, Tanos V, et al. Gynaecological endoscopic surgical education and assessment. A diploma programme in gynaecological endoscopic surgery. Eur J Obstet Gynecol Reprod Biol, 2016, 199: 183-186.
34.	李善姬, 顧卓偉, 施君, 等. 婦科內鏡手術培訓與考核體系在住培中期測評的價值研究. 中國繼續醫學教育, 2022, 14(6): 77-82.
35.	盧冠軍, 侯春麗, 侯學紅, 等. 腹腔鏡模擬訓練器在腹腔鏡培訓中的應用. 寧夏醫科大學學報, 2013, 10: 1153-1155,1194.
36.	張愛民, 戴一揚, Beller S, 等. 腹腔鏡模擬訓練在腔鏡外科中的應用. 中國微創外科雜志, 2008, 1: 7-10.
37.	王李, 徐琰, 黃彬, 等. 腹腔鏡外科基礎規范化教學在住培醫師教學中的應用. 中國繼續醫學教育, 2022, 14(16): 137-140.
38.	邱建國, 唐偉, 李明. 腹腔鏡模擬訓練系統在肝膽外科住院醫師規范化培訓中的應用研究. 現代醫藥衛生, 2020, 36(22): 3673-3675.
39.	Vassiliou MC, Feldman LS, Andrew CG, et al. A global assessment tool for evaluation of intraoperative laparoscopic skills. Am J Surg, 2005, 190(1): 107-113.
40.	Gumbs AA, Hogle NJ, Fowler DL. Evaluation of resident laparoscopic performance using global operative assessment of laparoscopic skills. J Am Coll Surg, 2007, 204(2): 308-313.
41.	Seagull FJ, Rooney DM. Filling a void: Developing a standard subjective assessment tool for surgical simulation through focused review of current practices. Surg, 2014, 156(3): 718-722.
42.	Ketel MHM, Klarenbeek BR, Eddahchouri Y, et al. Crowd-sourced and expert video assessment in minimally invasive esophagectomy. Surg Endosc, 2023, 37(10): 7819-7828.
43.	VAssiliou MC, Kaneva PA, Poulose BK, et al. Global Assessment of Gastrointestinal Endoscopic Skills (GAGES): A valid measurement tool for technical skills in flexible endoscopy. Surg Endosc, 2010, 24(8): 1834-41.
44.	廖虎, 蒲丹, 陳楠, 等. 華西智能化腔鏡技能訓練及考核系統的構建. 四川大學學報(醫學版), 2018, 49(5): 776-780.
45.	Zhou J, Liao H, Lin Z, et al. A new basic thoracoscopic surgical skill training and assessment system using automatic scoring techniques. Surg Endosc, 2022, 36(5): 3076-3086.
46.	Crochet P, Agostini A, Knight S, et al. The performance gap for residents in transfer of intracorporeal suturing skills from box trainer to operating room. J Surg Educ, 2017, 74(6): 1019-1027.

1. St John A, Caturegli I, Kubicki NS, et al. The rise of minimally invasive surgery: 16 year analysis of the progressive replacement of open surgery with laparoscopy. JSLS, 2020, 24(4): e 2020.00076.
2. 鄭民華, 馬君俊, 吳超. 微創外科近20年進展及未來發展趨勢. 中國實用外科雜志, 2020, 40(1): 23-26, 32.
3. 廖虎, 梅建東, 劉成武, 等. 中國三級醫院胸外科學科臨床發展現狀的調查研究. 中華外科雜志, 2018, 56(12): 888-891.
4. Cendan J, Wier D, Behrns K. A primer on standards setting as it applies to surgical education and credentialing. Sur Endoscopy, 2013, 27(7): 2631-2637.
5. Bendixen M, Jorgensen OD, Kronborg C, et al. Postoperative pain and quality of life after lobectomy via video-assisted thoracoscopic surgery or anterolateral thoracotomy for early stage lung cancer: a randomised controlled trial. Lancet Oncol, 2016, 17(6): 836-844.
6. Tang W, Zhang YF, Zhao YF, et al. Comparison of laparoscopic versus open radical antegrade modular pancreatosplenectomy for pancreatic cancer: A systematic review and meta-analysis. Int J Surg, 2022, 103: 106676.
7. Wong KC, Lee KF, Lo EYJ, et al. Minimally invasive versus open liver resection for hepatocellular carcinoma: A propensity score matching analysis of 224 patients. Langenbecks Arch Surg, 2023, 408(1): 118.
8. Munro M G. Surgical simulation: Where have we come from? Where are we now? Where are we going? J Minim Invasive Gynecol, 2012, 19(3): 272-283.
9. Sullivan ME. Applying the science of learning to the teaching and learning of surgical skills: The basics of surgical education. J Surg Oncol, 2020, 122(1): 5-10.
10. 夏揚, 李衛民. 利用模擬醫院培養腔鏡醫生臨床技能的探索與實踐. 中國職業技術教育, 2013, 11: 84-86.
11. Tarras SL, Thacker J, Bouwman DL, et al. Effective large group teaching for general surgery. Surg Clin North Am, 2021, 101(4): 565-576.
12. Ferguson MK, Bennett C. Identification of essential components of thoracoscopic lobectomy and targets for simulation. Ann Thorac Surg, 2017, 103(4): 1322-1329.
13. 李永寧, 喻超, 李英, 等. 單中心腹腔鏡肝部分切除術學習曲線分析. 中華普外科手術學雜志(電子版), 2021, 15(4): 376-379.
14. 吳昊鈞, 汪大剛, 梁夢萍, 等. 結合術前三維重建的腹腔鏡肝切除術學習曲線研究. 肝膽胰外科雜志, 2022, 34(9): 537-542.
15. Cypel M, Yasufuku K. Complications during minimal invasive thoracic surgery: Are new surgeons prepared? Lancet Oncol, 2018, 19(1): 17-19.
16. Nashaat A, Sidhu HS, Yatham S, et al. Simulation training for lobectomy: A review of current literature and future directions. Eur J Cardiothorac Surg, 2019, 55(3): 386-394.
17. Orejuela FJ, Aschkenazi SO, Howard DL, et al. Gynecologic surgical skill acquisition through simulation with outcomes at the time of surgery: A systematic review and meta-analysis. Am J Obstet Gynecol, 2022, 227(1): 29.e1-29.e4.
18. Goldenberg MG, Garbens A, Szasz P, et al. Systematic review to establish absolute standards for technical performance in surgery. Br J Surg, 2017, 104(1): 13-21.
19. 張克勤, 李蜀婧, 畢罡. 內鏡與微創培訓在泌尿外科臨床教學中的應用. 局解手術學雜志, 2014, 23(3): 318-319.
20. 謝艷麗, 張冬雅, 韓麗萍. 宮腔鏡仿真模擬系統在婦科臨床培訓中的應用. 中國繼續醫學教育, 2022, 14(24): 113-117.
21. 王鳳蛟, 李雪鑫, 張磊, 等. 基于Lap Mentor的HACCP技術在住培醫生腔鏡培訓質控中的應用研究. 解放軍預防醫學雜志, 2020, 38(2): 75-77, 80.
22. 王春茂, 王雋, 韓鳴, 等. 虛擬仿真腔鏡模擬訓練器在胸外科住院醫師培訓中的應用探討. 中國醫刊, 2023, 58(8): 923-926.
23. 鄧建華, 吳海坤, 李薇, 等. 北京協和醫院基于SMART原則的泌尿外科專科腔鏡規范化培訓的經驗總結. 中國醫學科學院學報, 2023, 45(1): 88-91.
24. 胡孔旺, 陸明, 王宜文, 等. 三層次培訓在規培生腔鏡技能培訓中的應用研究. 中國高等醫學教育, 2017, 11: 9-10.
25. 李曉軍, 張佳, 張靖, 等. 胸外科住院醫師規范化培訓中胸腔鏡手術的培養與訓練. 臨床醫學研究與實踐, 2018, 3(8): 195-196.
26. Vassiliou MC, Dunkin BJ, Marks JM, et al. FLS and FES: comprehensive models of training and assessment. Surg Clin North Am, 2010, 90(3): 535-558.
27. Castellvi AO, Hollett LA, Minhajuddin A, et al. Maintaining proficiency after fundamentals of laparoscopic surgery training: A 1-year analysis of skill retention for surgery residents. Surg, 2009, 146(2): 387-93.
28. Rooney DM, Santos BF, Hungness ES. Fundamentals of laparoscopic surgery (FLS) manual skills assessment: Surgeon vs nonsurgeon raters. J Surg Educ, 2012, 69(5): 588-592.
29. Higgins RM, Turbati MS, Goldblatt MI. Preparing for and passing the fundamentals of laparoscopic surgery (FLS) exam improves general surgery resident operative performance and autonomy. Surg Endosc, 2023, 37(8): 6438-6444.
30. Sansregret A, Fried GM, Hasson H, et al. Choosing the right physical laparoscopic simulator? Comparison of LTS2000-ISM60 with MISTELS: Validation, correlation, and user satisfaction. Am J Surg, 2009, 197(2): 258-65.
31. Lazar A, Sroka G, Laufer S. Automatic assessment of performance in the FLS trainer using computer vision. Surg Endosc, 2023, 37(8): 6476-6482.
32. Clark NV, Pepin KJ, Einarsson JI. Surgical skills assessment tools in gynecology. Curr Opin Obstet Gynecol, 2018, 30(5): 331-336.
33. Campo R, Wattiez A, Tanos V, et al. Gynaecological endoscopic surgical education and assessment. A diploma programme in gynaecological endoscopic surgery. Eur J Obstet Gynecol Reprod Biol, 2016, 199: 183-186.
34. 李善姬, 顧卓偉, 施君, 等. 婦科內鏡手術培訓與考核體系在住培中期測評的價值研究. 中國繼續醫學教育, 2022, 14(6): 77-82.
35. 盧冠軍, 侯春麗, 侯學紅, 等. 腹腔鏡模擬訓練器在腹腔鏡培訓中的應用. 寧夏醫科大學學報, 2013, 10: 1153-1155,1194.
36. 張愛民, 戴一揚, Beller S, 等. 腹腔鏡模擬訓練在腔鏡外科中的應用. 中國微創外科雜志, 2008, 1: 7-10.
37. 王李, 徐琰, 黃彬, 等. 腹腔鏡外科基礎規范化教學在住培醫師教學中的應用. 中國繼續醫學教育, 2022, 14(16): 137-140.
38. 邱建國, 唐偉, 李明. 腹腔鏡模擬訓練系統在肝膽外科住院醫師規范化培訓中的應用研究. 現代醫藥衛生, 2020, 36(22): 3673-3675.
39. Vassiliou MC, Feldman LS, Andrew CG, et al. A global assessment tool for evaluation of intraoperative laparoscopic skills. Am J Surg, 2005, 190(1): 107-113.
40. Gumbs AA, Hogle NJ, Fowler DL. Evaluation of resident laparoscopic performance using global operative assessment of laparoscopic skills. J Am Coll Surg, 2007, 204(2): 308-313.
41. Seagull FJ, Rooney DM. Filling a void: Developing a standard subjective assessment tool for surgical simulation through focused review of current practices. Surg, 2014, 156(3): 718-722.
42. Ketel MHM, Klarenbeek BR, Eddahchouri Y, et al. Crowd-sourced and expert video assessment in minimally invasive esophagectomy. Surg Endosc, 2023, 37(10): 7819-7828.
43. VAssiliou MC, Kaneva PA, Poulose BK, et al. Global Assessment of Gastrointestinal Endoscopic Skills (GAGES): A valid measurement tool for technical skills in flexible endoscopy. Surg Endosc, 2010, 24(8): 1834-41.
44. 廖虎, 蒲丹, 陳楠, 等. 華西智能化腔鏡技能訓練及考核系統的構建. 四川大學學報(醫學版), 2018, 49(5): 776-780.
45. Zhou J, Liao H, Lin Z, et al. A new basic thoracoscopic surgical skill training and assessment system using automatic scoring techniques. Surg Endosc, 2022, 36(5): 3076-3086.
46. Crochet P, Agostini A, Knight S, et al. The performance gap for residents in transfer of intracorporeal suturing skills from box trainer to operating room. J Surg Educ, 2017, 74(6): 1019-1027.

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Analysis and discussion of the research status of thoracoscopic and laparoscopicsimulation training and assessment

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