Introduction : We designed a new skill assessment system for the suture ligature method employing a model of intestinal anastomosis for laparoscopic surgery, and examined the usefulness of this system.
Materials & Methods : In this system, the internal pressure of the model was measured by the leak test using the air pressure as an indicator of dehiscence. The new artificial intestinal anastomosis model (artificial model) has an intestine-like structure. Expert surgeons (expert group) and medical students (novice group) performed a suturing task by putting stitches in a 10 mm wound in the artificial model and in a pig's intestine (tissue model). The performance time and the internal pressure of each model were then compared by the means between the two groups.
Results : The performance time of the expert group was found to be significantly shorter for both models than that of the novice group (p<0.01). The internal pressure of the expert group in the artificial model was also significantly higher than that of the novice group (p<0.05).
Conclusion : The system was found to be a potentially useful objective suturing skill assessment. Laparoscopic surgery, Clinical skills, Training, Education, Skill assessment

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As a new surgical device to accomplish both maximum tumor removal and functional preservation, Laser Induced Liquid Jet (LILJ) has been developed. Since 2011, the multicenter clinical trial has commenced intended pituitary tumor removal in 7 hospitals, all of whom were assigned to high volume center of pituitary tumor treatment in Japan, and they encountered over 100 cases in total. From the questionnaire filled by the surgeons, the surgeons desired the usability of LILJ hand piece to be improved. In this study, we designed and attached a new grip adapter for hand piece, and evaluated it in terms of weight center control, moment, and robustness against disturbance input in ergonomic experiments. In the results, the hand piece with the new grip adapter accomplished the reduction of the applied force by each finger from 1.4 to 0.4 mN (29%) and the error distance by mistaken fire from 19.5 to 9.1 mm (47%). Hence, the stability and operability of the LILJ hand piece were progressed.

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