Validation of a pediatric single-port laparoscopic surgery simulator.

BACKGROUND: This study aims to adapt an existing multiport pediatric laparoscopic surgery simulator to be suitable for pediatric single-port laparoscopy and to investigate construct validity for its use as a resource for skills training and assessment. METHODS: An existing pediatric-sized box trainer was modified to accommodate a commercially available port. A total of 41 participants (18 novices, 16 intermediates and 7 experts) were recruited to complete four curriculum tasks via a single-port access approach. Objective task performance scores were evaluated. RESULTS: Task completion times and performance scores were significantly different between novices and experts for the peg transfer (P = 0.02, P = 0.008 respectively), pattern cut (P < 0.001, P < 0.001 respectively) and ligating loop (P = 0.038, P = 0.035 respectively). There were significant differences in outcomes between novices and intermediates for all tasks, including the intracorporeal suture task (P ≤ 0.001). There were no significant differences in outcomes between intermediates and experts for all tasks. CONCLUSIONS: The Pediatric Laparoscopic Surgery (PLS) simulator can be easily adapted for single-port laparoscopic surgery to be construct valid for the peg transfer, ligating loop and pattern cut tasks. There is scope for additional tasks to be developed that focus on the unique technical challenges and skills associated with single-port techniques.

Computer-assisted transoral surgery with flexible robotics and navigation technologies: a review of recent progress and research challenges.

This article reviews the flexible robotic surgery and navigation technologies that are currently available and under research development, in particular for transoral robotic surgery, in both broad and narrow senses. The clinical background, classifications, associated biomedical robotics applications, and surgical outcomes are illustrated in this new paradigm of minimally invasive surgery. The state-of-the-art robotic and navigation systems for transoral procedures are reviewed by identifying their key properties and considerations. The use of different materials and actuation methods by current robotic systems offers various movements for different purposes, and their characteristics are compared. The future research trends of robotic and navigation systems for transoral procedures are discussed in terms of emerging new material, actuation, and sensing technologies.