BESTA: Ligating Loop
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The task “Endoloop” is a part of FLS Course (Fundamentals of Laparoscopic Surgery).
- Proper loop positioning;
- Secure the knot by running down the rod of the pusher;
- Visual-spatial orientation;
- Fulcrum effect compensation;
- Coordinated movements of both instruments;
- Ergonomic body and hands position.
Equipment: Dissector to grasper 5 mm; pusher 5 mm with round hole; Metzenbaum curved scissors; red foam organ with 3 appendages; silk or other dark braided suture 75-120 cm long.
Setup: Place the foam organ into the jumbo clip with three appendages hanging out towards you. Locate the clip onto the distal velcro strip and adjust camera so that the foam is in the middle of the field of view. Pre-tied ligating loop with Roeder knot.
Aim of the task: Place Endo-Loop on the marked appendage and cut off the thread.
Performance: Introduce dissector and pusher with the knot into the trainer. Booth assistance with the Maryland dissector (or grasper) or one-handed technique are allowed. A locking grasper may be used to enable the use of two hands to manipulate the ligating loop.Once the loop is positioned secure the knot on the mark of the foam appendage by sliding the pusher rod down. Complete the task by cutting the end of your loop material inside the trainer.
The task should be practiced until it can be performed in 53 seconds with up to 1mm accuracy errors; this level of performance should be achieved on 2 consecutive repetitions or for a maximum of 80 repetitions.
Start: The first instrument is visible on the screen.
Finish: Thread has been cut inside the trainer and instruments removed.
- Time limit (sec): 180
- Target time (sec): 53
- Precision: placed on mark (<1,0 mm)
- Passing score: 100
- Path: left and right instruments
- Ambidexterity, %: not relevant
- Speed: overage left and right; maximal left and right instruments
Instrument pulls too hard;
Non-ergonomic position of the trainee, leading to back or hands strain;
Rotating wheel of scissors was not used when necessary.
Deviation of the loop from the mark more than 1 mm.
Wrong performance of the task.
The foam organ is detached from the clip.
The slit in the drain is not closed.
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Time limit (sec): 180 Time target (sec): 53 Number of points: 100 Ambidexterity, %: 0 Evaluated parameters: Standard Parameters, Loop placement precision Formula: Score = 236 – t (sec) - Penalty
Compare with you:
X Date Attempt
Path, mm Av.Speed, mm/sec Max.Speed, mm/sec
Target values: 100 53 - - 0 - - - - - -