Does the incorporation of motion metrics into the existing FLS metrics lead to improved skill acquisition on simulators? A single blinded, randomized controlled trial.


OBJECTIVE:We hypothesized that training to expert-derived levels of speed and motion will lead to improved learning and will translate to better operating room (OR) performance of novices than training to goals of speed or motion alone. BACKGROUND:Motion tracking has been suggested to be a more sensitive performance metric than time and errors for the assessment of surgical performance. METHODS:An institutional review board-approved, single blinded, randomized controlled trial was conducted at our level-I American College of Surgeons accredited Education Institute. Forty-two novices trained to proficiency in laparoscopic suturing after being randomized into 3 groups: The speed group (n = 14) had to achieve expert levels of speed, the motion group (n = 15) expert levels of motion (path length and smoothness), and the speed and motion group (n = 13) both levels. To achieve proficiency, all groups also had to demonstrate error-free performance. The FLS suture module (task 5) was used for training inside the ProMIS simulator that tracks instrument motion. All groups participated in transfer and retention tests in the OR. OR performance was assessed by a blinded expert rater using Global Operative Assessment of Laparoscopic Skills, speed, accuracy, and inadvertent injuries. RESULTS:Thirty (71%) participants achieved proficiency and participated in the transfer and retention tests. The speed group achieved simulator proficiency significantly faster than the other groups (P < 0.001). With the exception of a higher injury rate during the transfer test for the speed group (that reversed during the retention test), there were no significant performance differences among the groups on all assessed parameters. CONCLUSIONS:The incorporation of motion metrics into the time/accuracy goals of the FLS laparoscopic suturing curriculum had limited impact on participant skill transfer to the OR. Given the increased training requirements for such a curriculum, further study is needed before the addition of motion metrics to the current FLS metrics can be recommended.


Ann Surg


Annals of surgery


Stefanidis D,Yonce TC,Korndorffer JR Jr,Phillips R,Coker A




Has Abstract


2013-07-01 00:00:00












  • Positive mobilization margins alone do not influence survival following pancreatico-duodenectomy for pancreatic ductal adenocarcinoma.

    abstract:OBJECTIVE:To determine the prognostic influence of residual tumor at or within 1 mm of the mobilization margins (R1Mobilization) compared with transection margins (R1Transection) following pancreaticoduodenectomy for pancreatic ductal adenocarcinoma (PDAC). BACKGROUND:The prognostic strength of R1 status increases wit...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Jamieson NB,Foulis AK,Oien KA,Going JJ,Glen P,Dickson EJ,Imrie CW,McKay CJ,Carter R

    更新日期:2010-06-01 00:00:00

  • Percutaneous transhepatic bile drainage.

    abstract::Percutaneous transhepatic bile drainage was performed in 13 patients with obstructive jaundice, using a combination of the PTC technique and a Seldinger angiography catheter. In 11 cases, the outflow of bile through the catheter was satisfactory and complications were few. Since the risk of the procedure is low and it...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Mori K,Misumi A,Sugiyama M,Okabe M,Matsuoka T

    更新日期:1977-01-01 00:00:00

  • Minimally invasive esophagectomy: outcomes in 222 patients.

    abstract:OBJECTIVE:To assess our outcomes after minimally invasive esophagectomy (MIE). SUMMARY BACKGROUND DATA:Esophagectomy has traditionally been performed by open methods. Results from most series include mortality rates in excess of 5% and hospital stays frequently greater than 10 days. MIE has the potential to improve th...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Luketich JD,Alvelo-Rivera M,Buenaventura PO,Christie NA,McCaughan JS,Litle VR,Schauer PR,Close JM,Fernando HC

    更新日期:2003-10-01 00:00:00

  • Prerandomization Surgical Training for the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-32 trial: a randomized phase III clinical trial to compare sentinel node resection to conventional axillary dissection in clinically node-negative bre

    abstract:OBJECTIVE:To train surgeons in a standardized technique of sentinel lymph node biopsy and to prepare them for the requirements of a prospective randomized surgical trial. SUMMARY BACKGROUND DATA:The NSABP B32 trial opened to accrual in May 1999. A significant component of this trial was a prerandomization training pha...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Harlow SP,Krag DN,Julian TB,Ashikaga T,Weaver DL,Feldman SA,Klimberg VS,Kusminsky R,Moffat FL Jr,Noyes RD,Beitsch PD

    更新日期:2005-01-01 00:00:00

  • Carcinoma of the ampulla of Vater: Review of 38 cases with emphasis on treatment and prognostic factors.

    abstract::Thirty-eight cases of carcinoma of the ampulla of Vater are presented. The diagnosis has been confirmed at laparatomy in all patients. Three operations were done, a pancreaticoduodenal resection in 23 patients, a biliary-enteric bypass in 7 patients and a biliary-enteric bypass plus excision of tumor in 8 patients. Th...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Makipour H,Cooperman A,Danzi JT,Farmer RG

    更新日期:1976-04-01 00:00:00

  • Cost-effectiveness of Enhanced Recovery Versus Conventional Perioperative Management for Colorectal Surgery.

    abstract:OBJECTIVE:To determine the cost-effectiveness of enhanced recovery pathways (ERPs) versus conventional care for patients undergoing elective colorectal surgery. BACKGROUND:ERPs for colorectal surgery are clinically effective, but their cost-effectiveness is unknown. METHODS:A multi-institutional prospective cohort co...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,多中心研究


    authors: Lee L,Mata J,Ghitulescu GA,Boutros M,Charlebois P,Stein B,Liberman AS,Fried GM,Morin N,Carli F,Latimer E,Feldman LS

    更新日期:2015-12-01 00:00:00

  • Clinical significance of the mesorectal extension of rectal cancer: a Japanese multi-institutional study.

    abstract:OBJECTIVE:The aim of this study was to emphasize the importance of a subclassification in the TNM staging system of rectal cancer. BACKGROUND:The clinical significance of the mesorectal extension of rectal cancer is unclear. PATIENTS AND METHODS:Data from 463 consecutive patients with stage IIa disease (T3N0) undergo...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究


    authors: Shirouzu K,Akagi Y,Fujita S,Ueno H,Takii Y,Komori K,Ito M,Sugihara K,Japanese Society for Cancer of the Colon and Rectum (JSCCR) on Clinical Significance of the Mesorectal Extension of Rectal Cancer.

    更新日期:2011-04-01 00:00:00

  • Improved kidney graft function after preservation using a novel hypothermic machine perfusion device.

    abstract:OBJECTIVE:To study graft function and ischemia/reperfusion injury of porcine kidneys after preservation with the new Groningen Machine Perfusion (GMP) system versus static cold storage (CS). INTRODUCTION:The increasing proportion of marginal and nonheart beating donors necessitates better preservation methods to maint...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Maathuis MH,Manekeller S,van der Plaats A,Leuvenink HG,'t Hart NA,Lier AB,Rakhorst G,Ploeg RJ,Minor T

    更新日期:2007-12-01 00:00:00

  • Proficiency of surgeons in inguinal hernia repair: effect of experience and age.

    abstract:OBJECTIVES:We examined the influence of surgeon age and other factors on proficiency in laparoscopic or open hernia repair. SUMMARY BACKGROUND DATA:In a multicenter, randomized trial comparing open and laparoscopic herniorrhaphies, conducted in Veterans Administration hospitals (CSP 456), we reported significant diffe...

    journal_title:Annals of surgery

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Neumayer LA,Gawande AA,Wang J,Giobbie-Hurder A,Itani KM,Fitzgibbons RJ Jr,Reda D,Jonasson O,CSP #456 Investigators.

    更新日期:2005-09-01 00:00:00

  • Neurovascular compression in the thoracic outlet: changing management over 50 years.

    abstract:SUMMARY BACKGROUND DATA:During the past five decades, significant improvements have been made in the diagnosis and treatment of thoracic outlet syndrome (TOS) secondary to sports activities, breast implants, or median sternotomy. METHODS, RESULTS, AND CONCLUSIONS:Of more than 15,000 patients evaluated for TOS, 3914 un...

    journal_title:Annals of surgery

    pub_type: 杂志文章,评审


    authors: Urschel HC Jr,Razzuk MA

    更新日期:1998-10-01 00:00:00

  • Intestinal Oxygenation and Survival After Surgery for Necrotizing Enterocolitis: An Observational Cohort Study.

    abstract:OBJECTIVE:To assess whether regional intestinal oxygen saturation (rintSO2) and regional cerebral oxygen saturation (rcSO2) measurements aid in estimating survival of preterm infants after surgery for NEC. SUMMARY OF BACKGROUND DATA:Predicting survival after surgery for NEC is difficult yet of the utmost importance fo...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Kuik SJ,van der Heide M,Bruggink JLM,Bos AF,Verhagen AAE,Kooi EMW,Hulscher JBF

    更新日期:2020-04-20 00:00:00

  • Efficacy and Safety of Glutamine-supplemented Parenteral Nutrition in Surgical ICU Patients: An American Multicenter Randomized Controlled Trial.

    abstract:OBJECTIVE:To determine whether glutamine (GLN)-supplemented parenteral nutrition (PN) improves clinical outcomes in surgical intensive care unit (SICU) patients. SUMMARY BACKGROUND DATA:GLN requirements may increase with critical illness. GLN-supplemented PN may improve clinical outcomes in SICU patients. METHODS:A p...

    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Ziegler TR,May AK,Hebbar G,Easley KA,Griffith DP,Dave N,Collier BR,Cotsonis GA,Hao L,Leong T,Manatunga AK,Rosenberg ES,Jones DP,Martin GS,Jensen GL,Sax HC,Kudsk KA,Galloway JR,Blumberg HM,Evans ME,Wischmeyer PE

    更新日期:2016-04-01 00:00:00

  • Vein cuff interposition prevents juxta-anastomotic neointimal hyperplasia.

    abstract::This study sought to minimize juxta-anastomotic neointimal hyperplasia (JNIH) following the use of polytetrafluorethylene (PTFE) conduits. PTFE anastomoses to canine carotid arteries (noncuff grafts) were compared with grafts with vein cuffs interposed proximally and distally between the graft and native artery. This ...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Suggs WD,Henriques HF,DePalma RG

    更新日期:1988-06-01 00:00:00

  • Major complications, mortality, and resource utilization after open abdominal surgery: 0.9% saline compared to Plasma-Lyte.

    abstract:OBJECTIVE:To assess the association of 0.9% saline use versus a calcium-free physiologically balanced crystalloid solution with major morbidity and clinical resource use after abdominal surgery. BACKGROUND:0.9% saline, which results in a hyperchloremic acidosis after infusion, is frequently used to replace volume loss...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Shaw AD,Bagshaw SM,Goldstein SL,Scherer LA,Duan M,Schermer CR,Kellum JA

    更新日期:2012-05-01 00:00:00

  • Case managers in mass casualty incidents.

    abstract:OBJECTIVE:To examine whether case managers affect patient evaluation/treatment/outcome and staffing requirements during Multiple Casualty Incidents (MCIs). SUMMARY BACKGROUND DATA:Multiple patient relocations during MCIs may contribute to chaos. One hospital changed its MCI patient relocation policy during a wave of M...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Einav S,Schecter WP,Matot I,Horn JK,Hersch M,Reissman P,Spira RM

    更新日期:2009-03-01 00:00:00

  • Donating a Kidney to a Stranger: A Review of the Benefits and Controversies of Unspecified Kidney Donation.

    abstract:OF BACKGROUND DATA:Unspecified kidney donation (UKD) describes living donation of a kidney to a stranger. The practice is playing an increasingly important role within the transplant programme in the United Kingdom, where these donors are commonly used to trigger a chain of transplants; thereby amplifying the benefit d...

    journal_title:Annals of surgery

    pub_type: 杂志文章,评审


    authors: Maple H,Draper H,Gogalniceanu P,Burnapp L,Chilcot J,Mamode N

    更新日期:2020-07-01 00:00:00

  • Clinical application of cytochrome a(plus a3) assay of mitochondria from liver specimens: an aid in determining metabolic tolerance of liver remnant for hepatic resection.

    abstract::Measurement of cytochrome a(+a(3)) contents in liver mitochondria was made on 52 biopsy specimens of patients with liver tumor. Patients having higher cytochrome a(+a(3)) contents in mitochondria from remaining liver than those of normal human liver mitochondria could survive well major liver resections whether or not...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Ozawa K,Yamaoka Y,Kitamura O,Nambu H,Kamiyama Y

    更新日期:1974-12-01 00:00:00

  • A prognostic nomogram for prediction of recurrence in desmoid fibromatosis.

    abstract:OBJECTIVE:To construct a postoperative nomogram to estimate the risk of local recurrence for patients with desmoid tumors. BACKGROUND:The standard management of desmoid tumors is resection, but many recur locally. Other options include observation or novel chemotherapeutics, but little guidance exists on selecting tre...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Crago AM,Denton B,Salas S,Dufresne A,Mezhir JJ,Hameed M,Gonen M,Singer S,Brennan MF

    更新日期:2013-08-01 00:00:00

  • Surgical management of abdominal aortic aneurysms: factors influencing mortality and morbidity--a 20-year experience.

    abstract::Abdominal aortic aneurysmectomy is being performed with progressively lower operative mortality and morbidity. Three hundred thirty seven patients have had elective aneurysm repair since 1954. Factors affecting mortality and morbidity in the last 108 cases are analyzed. Seventy-four per cent of patients had pre-existi...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Thompson JE,Hollier LH,Patman RD,Persson AV

    更新日期:1975-05-01 00:00:00

  • Do differences in hospital and surgeon quality explain racial disparities in lower-extremity vascular amputations?

    abstract:OBJECTIVE:To understand whether racial disparities in surgery for lower-extremity arterial disease are minimized by high-quality providers, or instead, differential treatment of otherwise similar patients pervades all settings. SUMMARY BACKGROUND DATA:Black patients are substantially more likely than whites to undergo...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Regenbogen SE,Gawande AA,Lipsitz SR,Greenberg CC,Jha AK

    更新日期:2009-09-01 00:00:00

  • Impact of Weekday of Esophagectomy on Short-term and Long-term Oncological Outcomes: A Nationwide Population-based Cohort Study in the Netherlands.

    abstract:OBJECTIVE:The aim of this study was to determine whether weekday of esophagectomy impacts 30-day mortality, and short- and long-term oncologic outcomes in esophageal cancer. SUMMARY OF BACKGROUND DATA:Recent literature suggests a relationship between the weekday of esophagectomy and overall survival. This finding coul...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Visser E,van Rossum PSN,Verhoeven RHA,Ruurda JP,van Hillegersberg R

    更新日期:2017-07-01 00:00:00

  • When Do DCD Donors Die?: Outcomes and Implications of DCD at a High-volume, Single-center OPO in the United States.

    abstract:OBJECTIVE:The objective of this study was to determine the fate of patients who attempted to donate organs after circulatory death (DCD) using a standardized DCD protocol. BACKGROUND:Successful donation is not always possible after attempted DCD. METHODS:Data were collected for all DCD donors between 1/2011 and 9/201...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Scalea JR,Redfield RR,Rizzari MD,Bennett R,Anderson ME,Anderson JE,Kaufman DB,Sollinger HW,Fernandez LA,D'Alessandro AM,Mezrich J

    更新日期:2016-02-01 00:00:00

  • The preoperative and intraoperative hemodynamic predictors of postoperative myocardial infarction or ischemia in patients undergoing noncardiac surgery.

    abstract::Among hypertensive and diabetic patients undergoing elective noncardiac surgery, preoperative status and intraoperative changes in mean arterial pressure (MAP) were evaluated as predictors of postoperative ischemic complications. Of 254 patients evaluated before operation and monitored during operation, 30 (12%) had p...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Charlson ME,MacKenzie CR,Gold JP,Ales KL,Topkins M,Fairclough GP Jr,Shires GT

    更新日期:1989-11-01 00:00:00

  • Failure of institutionally derived predictive models of conversion in laparoscopic colorectal surgery to predict conversion outcomes in an independent data set of 998 laparoscopic colorectal procedures.

    abstract:OBJECTIVE:The aim of this study was to perform an external validation of 2 institutionally derived predictive models of laparoscopic conversion in colorectal surgery using the Mayo Clinic, Rochester (MCR) laparoscopic colon and rectal surgery experience. SUMMARY OF BACKGROUND DATA:Two different predictive scoring syst...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Cima RR,Hassan I,Poola VP,Larson DW,Dozois EJ,Larson DR,O'Byrne MM,Huebner M

    更新日期:2010-04-01 00:00:00

  • Predicting risk for serious complications with bariatric surgery: results from the Michigan Bariatric Surgery Collaborative.

    abstract:OBJECTIVES:To develop a risk prediction model for serious complications after bariatric surgery. BACKGROUND:Despite evidence for improved safety with bariatric surgery, serious complications remain a concern for patients, providers and payers. There is little population-level data on which risk factors can be used to ...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Finks JF,Kole KL,Yenumula PR,English WJ,Krause KR,Carlin AM,Genaw JA,Banerjee M,Birkmeyer JD,Birkmeyer NJ,Michigan Bariatric Surgery Collaborative, from the Center for Healthcare Outcomes and Policy.

    更新日期:2011-10-01 00:00:00

  • Management of adult choledochal cysts.

    abstract::A review of the English literature reveals a total of 1,337 patients with choledochal cysts. Improved diagnostic techniques to visualize the biliary system are demonstrating an increasing number of unsuspected choledochal cysts in adult patients. Either choledochal cysts remain clinically silent until adulthood or may...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Powell CS,Sawyers JL,Reynolds VH

    更新日期:1981-05-01 00:00:00

  • Do Surgeons React?: A Retrospective Analysis of Surgeons' Response to Harassment of a Colleague During Simulated Operating Theatre Scenarios.

    abstract:OBJECTIVE:To assess and report on surgeons' ability to identify and manage incidences of harassment. BACKGROUND:The Royal Australasian College of Surgeons is committed to driving out discrimination, bullying, harassment, and sexual harassment from surgical training and practice, through changing the culture of the wor...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Gostlow H,Vega CV,Marlow N,Babidge W,Maddern G

    更新日期:2018-08-01 00:00:00

  • Prognostic significance of DNA replication errors in young patients with colorectal cancer.

    abstract:OBJECTIVE:To determine the DNA replication error (RER) status in young patients with colorectal cancer (CRC), and to compare the clinical and pathologic characteristics of RER-positive and RER-negative cases. SUMMARY BACKGROUND DATA:Recent studies suggest that patients with RER-positive CRC have an improved prognosis....

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Lukish JR,Muro K,DeNobile J,Katz R,Williams J,Cruess DF,Drucker W,Kirsch I,Hamilton SR

    更新日期:1998-01-01 00:00:00

  • Parasympathetic innervation and pancreatic secretion: the role of the gastric antrum.

    abstract::The role of the antrum on vagally mediated pancreatic secretion was studied in 8 conscious dogs prepared with chronic pancreatic and gastric fistulae. After completion of control studies 6 were subjected to antrectomy and 2 to antroneurolysis (to interrupt submucosal nerve connections); secretory studies were repeated...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Rosenberg IR,Zambrano VJ,Janowitz HD,Rudick J

    更新日期:1976-03-01 00:00:00

  • Angiopoietin-2, marker and mediator of endothelial activation with prognostic significance early after trauma?

    abstract:OBJECTIVE:To measure plasma levels of angiopoietin-1 (Ang-1), angiopoietin-2 (Ang-2), and vascular endothelial growth factor (VEGF) early after trauma and to determine their clinical significance. BACKGROUND:Angiopoietins and VEGF play a central role in the physiology and pathophysiology of endothelial cells. Ang-2 ha...

    journal_title:Annals of surgery

    pub_type: 杂志文章


    authors: Ganter MT,Cohen MJ,Brohi K,Chesebro BB,Staudenmayer KL,Rahn P,Christiaans SC,Bir ND,Pittet JF

    更新日期:2008-02-01 00:00:00