Background As laparoscopic colorectal cancer surgery becomes more common in mid-sized municipal hospitals in Japan, young trainees have increasing opportunities to attend laparoscopic colorectomy procedures as a scope operator. However, the performance of the inexperienced scope operator may affect the operative outcome. This study aims to provide a quantitative measure of the scope operator’s performance, by analyzing scope contamination events, and to determine the influence of this measure on surgical outcomes.
Methods We retrospectively analyzed the operative videos of 70 sigmoid colectomy or high anterior resection cases performed between February 2014 and July 2019 in our hospital. Twenty-four young surgeons alternated assisting with the procedure as the scope operator. To quantify the scope operators’ performance, the frequency of laparoscopic lens contamination events (FLC) during surgery was determined. The FLC and operative outcomes were compared among the first, second, and subsequent procedures performed by each scope operator. We identified the cause of lens contamination and surgical situation in which contamination occurred. We examined the relationship between the FLC and experience level of the scope operator for specific types of contamination and surgical situations.
Results A total of 733 lens contaminations were observed. The median FLC was 10 (minimum: 1, maximum: 34) during each operation. The FLC and number of procedures performed by the scope operator had a negative linear correlation. Multivariate analysis showed that the experience level of the scope operator was the only independent predictor of operation time. There was also a negative linear correlation between the number of procedures performed by the scope operator and scope contamination during colorectal mobilization.
Conclusions Scope operator experience decreases scope contamination and could facilitate the laparoscopic surgical workflow. The influence of the scope operator’s performance should be emphasized.