P R Shah1, P N Haray. 1. Cwm Taf NHS Trust, Prince Charles Hospital, Merthyr Tydfil, UK.
Abstract
AIM: Laparoscopic colorectal surgery includes operative procedures of varying complexity, and traditional assessment tools may not be enough to assess competence. This study defines quantitative tools for assessing proficiency in laparoscopic colorectal surgery. METHOD: A single surgeon's 11-year experience was subdivided into five phases with equal numbers of patients. A tool-kit, with specific tools defined as the complexity score, the conversion score, the technical score, the training score and the proficiency score, has been developed and used to evaluate each phase of the experience. RESULTS: There were 400 patients, with 80 in each of the five phases. The complexity score increased from 23.75 to 63.75 over the five phases. Similar increases were also demonstrable in the conversion score (from 0.45 to 15.45), the technical score (from 30 to 96.5), the training score (from 5.8 to 34.8) and the overall proficiency score (from 15 to 52.63). CONCLUSION: The results show that it is possible to quantify the workload in laparoscopic colorectal surgery and to assess increasing proficiency using a simple, reproducible and reliable tool-kit.
AIM: Laparoscopic colorectal surgery includes operative procedures of varying complexity, and traditional assessment tools may not be enough to assess competence. This study defines quantitative tools for assessing proficiency in laparoscopic colorectal surgery. METHOD: A single surgeon's 11-year experience was subdivided into five phases with equal numbers of patients. A tool-kit, with specific tools defined as the complexity score, the conversion score, the technical score, the training score and the proficiency score, has been developed and used to evaluate each phase of the experience. RESULTS: There were 400 patients, with 80 in each of the five phases. The complexity score increased from 23.75 to 63.75 over the five phases. Similar increases were also demonstrable in the conversion score (from 0.45 to 15.45), the technical score (from 30 to 96.5), the training score (from 5.8 to 34.8) and the overall proficiency score (from 15 to 52.63). CONCLUSION: The results show that it is possible to quantify the workload in laparoscopic colorectal surgery and to assess increasing proficiency using a simple, reproducible and reliable tool-kit.