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M Schijven

Publications and source records attributed to M Schijven.

6 recordsLinked to original sources
PubMed2003

The intercollegiate Basic Surgical Skills Course.

OBJECTIVE: This study was undertaken to establish residents' progress in minimal access surgery (MAS) after attending the Intercollegiate Basic Surgical Skills Course (BSSC) by means of the Xitact LS500 laparoscopy simulator assessment program. METHODS: Twenty-five surgical residents attended the BSSC in Leiden and Eindhoven, The Netherlands. Before and after the course, participants performed three "runs" on the Xitact LS500, featuring a standardized laparoscopic cholecystectomy clip-and-cut task. A control group of 25 interns not attending the course also performed two sessions of three runs. Parameters of interest were "score" and "time for completion of task". RESULTS: No significant differences were found within the resident group for the parameters "time" and "score" when comparing outcomes pre- and post-BSSC. No significant differences were found comparing time and score between residents and interns on each of the six runs, except for time in run 2. Over six runs, both residents and interns became significantly faster. CONCLUSIONS: The Xitact LS500 cholecystectomy simulator did not detect significant improvement in MAS performance among a group of surgical residents attending the BSSC.

Adult↗
PubMed2003

Construct validity: experts and novices performing on the Xitact LS500 laparoscopy simulator.

BACKGROUND: This study was undertaken to establish construct validity of the Xitact LS500, a virtual reality laparoscopic cholecystectomy simulator. The primary research statement is: "The clip-and-cut task on the Xitact LS500 virtual reality laparoscopic cholecystectomy simulator mimics the surgical procedure of the clipping and cutting of the cystic duct and artery during the laparoscopic cholecystectomy adequately." METHODS: According to the level of experience of the surgeon, an "expert group opinion" was formed resulting from 37 surgeons having performed over 100 laparoscopic cholecystectomies, and a "novice group opinion" was formed resulting of 37 surgeons having no experience at all with performing laparoscopic cholecystectomy. Participants received an instructed hands-on "tour" on the Xitact simulator and performed three formal simulation runs. RESULTS: The "novice group" is younger and more surgeons are female. Performance scores in the "expert" group are significantly higher on the second (p value 0.011) and third (p value 0.005) run, compared to the novices' scores. Experts are significantly faster on completion of all three runs. There is an increase in score over runs in both groups, which is statistically significant in the "expert group." Less than one-third of surgeons in either group are able to correctly predict their performance score as generated by Xitact. Both "experts" and "novices" feel it is useful to train with Xitact LS500 in the surgical curriculum. CONCLUSIONS: Three hypotheses, formulated to operationalize the primary research statement, could be answered affirmatively. Although further validation studies are needed, the Xitact LS500 simulator seems to be able to discriminate between expert and novice surgeons in this research setting, and thus the construct for this setting is considered to be valid.

Adult↗
PubMed2002

Face-, expert, and referent validity of the Xitact LS500 laparoscopy simulator.

BACKGROUND: This study was undertaken to establish face-, expert, and referent validity of the Xitact LS500; a virtual reality laparoscopic cholecystectomy simulator. METHODS: A four-page, 20-item structured questionnaire was presented to 120 surgeons attending a surgical convention. Participants received an instructed hands-on "tour" on the Xitact simulator. Data were analyzed according to the level of experience of the surgeon, resulting in an "expert group opinion" of 87 surgeons and a "referent group opinion" of 33 surgeons. RESULTS: The majority of respondents believe Xitact has the potential to become a useful tool in teaching (93.1%) and measuring performance assessment (79.3%) in laparoscopic cholecystectomy. Expert- and referent-group opinion does not differ significantly on any of the presented statements. The opinion regarding the realism of the virtual laparoscopic cholecystectomy environment is favorable among both groups, although it is considered not yet perfect. The "haptic feedback" sensation of the Xitact is a parameter that needs further development. CONCLUSIONS: Both expert- and referent surgeons value Xitact to be an important and useful tool in the laparoscopic teaching setting. Further studies need to be performed to establish the construct validity of the simulator (e.g., to what extent is the simulator logically encompassed into a theoretical framework of acquiring skills, needed for the laparoscopic cholecystectomy) to measure shortening of learning curves on the laparoscopic cholecystectomy procedure, and ultimately to justify its use in the surgical curriculum.

Adult↗
PubMed2001

Risk, severity and predictors of physical and psychological morbidity after axillary lymph node dissection for breast cancer.

The aim of this study was to investigate the nature and severity of the arm complaints among breast cancer patients after axillary lymph node dissection (ALND) and to study the effects of this treatment-related morbidity on daily life and well-being. 400 women, who underwent ALND as part of breast cancer surgery, filled out a treatment-specific quality of life questionnaire. The mean time since ALND was 4.7 years (range 0.3-28 years). More than 20% of patients reported pain, numbness, or loss of strength and 9% reported severe oedema. None of the complaints appeared to diminish over time. Irradiation of the axilla and supraclavicular irradiation were associated with a 3.57-fold higher risk of oedema (odds ratio (OR) 3.57; 95% confidence interval (CI) 1.66-7.69) causing many patients to give up leisure activities or sport. Women who underwent irradiation of the breast or chest wall more often reported to have a sensitive scar than women who did not receive radiotherapy. Women <45 years of age had an approximately 6 times higher risk of numbness of the arm (OR 6.49; 95% CI 2.58-16.38) compared with those > or = 65 years of age; they also encountered more problems doing their household chores. The results of the present study support the introduction of less invasive techniques for the staging of the axilla, sentinel node biopsy being the most promising.

Activities of Daily Living↗