Application of a novel surgical difficulty grading system during laparoscopic cholecystectomy

Koji Asai; Yukio Iwashita; Tetsuji Ohyama; Itaru Endo; Taizo Hibi; Akiko Umezawa; Kenji Suzuki; Manabu Watanabe; Masanao Kurata; Yasuhisa Mori; Masaharu Higashida; Yusuke Kumamoto; Junichi Shindoh; Masahiro Yoshida; Goro Honda; Takeyuki Misawa; Yuta Abe; Yuichi Nagakawa; Naoyuki Toyota; Shigetoshi Yamada; Shinji Norimizu; Naoki Matsumura; Naohiro Sata; Hiroki Sunagawa; Masahiro Ito; Yutaka Takeda; Yoshiharu Nakamura; Toshiki Rikiyama; Ryota Higuchi; Takeshi Gocho; Yuki Homma; Teijiro Hirashita; Hideyuki Kanemoto; Masashi Nozawa; Yusuke Watanabe; Atsushi Kohga; Takehisa Yazawa; Hiroshi Tajima; Shin Nakahira; Tadafumi Asaoka; Ryuji Yoshioka; Junya Fukuzawa; Shuichi Fujioka; Taigo Hata; Hidenori Haruta; Yukio Asano; Ryohei Nomura; Joe Matsumoto; Noriaki Kameyama; Atsushi Miyoshi; Hidejiro Urakami; Yasuji Seyama; Takanori Morikawa; Yoichi Kawano; Hisashi Ikoma; Dal Ho Kim Kin; Tadahiro Takada; Masakazu Yamamoto

doi:10.1002/jhbp.1068

Application of a novel surgical difficulty grading system during laparoscopic cholecystectomy

Koji Asai, Yukio Iwashita, Tetsuji Ohyama, Itaru Endo, Taizo Hibi, Akiko Umezawa, Kenji Suzuki, Manabu Watanabe, Masanao Kurata, Yasuhisa Mori, Masaharu Higashida, Yusuke Kumamoto, Junichi Shindoh, Masahiro Yoshida, Goro Honda, Takeyuki Misawa, Yuta Abe, Yuichi Nagakawa, Naoyuki Toyota, Shigetoshi YamadaShinji Norimizu, Naoki Matsumura, Naohiro Sata, Hiroki Sunagawa, Masahiro Ito, Yutaka Takeda, Yoshiharu Nakamura, Toshiki Rikiyama, Ryota Higuchi, Takeshi Gocho, Yuki Homma, Teijiro Hirashita, Hideyuki Kanemoto, Masashi Nozawa, Yusuke Watanabe, Atsushi Kohga, Takehisa Yazawa, Hiroshi Tajima, Shin Nakahira, Tadafumi Asaoka, Ryuji Yoshioka, Junya Fukuzawa, Shuichi Fujioka, Taigo Hata, Hidenori Haruta, Yukio Asano, Ryohei Nomura, Joe Matsumoto, Noriaki Kameyama, Atsushi Miyoshi, Hidejiro Urakami, Yasuji Seyama, Takanori Morikawa, Yoichi Kawano, Hisashi Ikoma, Dal Ho Kim Kin, Tadahiro Takada, Masakazu Yamamoto

Research output: Contribution to journal › Article › peer-review

13 Citations (Scopus)

Abstract

Background: Prevention of bile duct injury and vasculo-biliary injury while performing laparoscopic cholecystectomy (LC) is an unsolved problem. Clarifying the surgical difficulty using intraoperative findings can greatly contribute to the pursuit of best practices for acute cholecystitis. In this study, multiple evaluators assessed surgical difficulty items in unedited videos and then constructed a proposed surgical difficulty grading. Methods: We previously assembled a library of typical video clips of the intraoperative findings for all LC surgical difficulty items in acute cholecystitis. Fifty-one experts on LC assessed unedited surgical videos. Inter-rater agreement was assessed by Fleiss's κ and Gwet's agreement coefficient (AC). Results: Except for one item (“edematous change”), κ or AC exceeded 0.5, so the typical videos were judged to be applicable. The conceivable surgical difficulty gradings were analyzed. According to the assessment of difficulty factors, we created a surgical difficulty grading system (agreement probability = 0.923, κ = 0.712, 90% CI: 0.587-0.837; AC₂ = 0.870, 90% CI: 0.768-0.972). Conclusion: The previously published video clip library and our novel surgical difficulty grading system should serve as a universal objective tool to assess surgical difficulty in LC.

Original language	English
Pages (from-to)	758-767
Number of pages	10
Journal	Journal of Hepato-Biliary-Pancreatic Sciences
Volume	29
Issue number	7
DOIs	https://doi.org/10.1002/jhbp.1068
Publication status	Published - 07-2022

All Science Journal Classification (ASJC) codes

Surgery
Hepatology

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Asai, K., Iwashita, Y., Ohyama, T., Endo, I., Hibi, T., Umezawa, A., Suzuki, K., Watanabe, M., Kurata, M., Mori, Y., Higashida, M., Kumamoto, Y., Shindoh, J., Yoshida, M., Honda, G., Misawa, T., Abe, Y., Nagakawa, Y., Toyota, N., ... Yamamoto, M. (2022). Application of a novel surgical difficulty grading system during laparoscopic cholecystectomy. Journal of Hepato-Biliary-Pancreatic Sciences, 29(7), 758-767. https://doi.org/10.1002/jhbp.1068

@article{1bbcb99b0a8240f0a616c91a6409892b,

title = "Application of a novel surgical difficulty grading system during laparoscopic cholecystectomy",

abstract = "Background: Prevention of bile duct injury and vasculo-biliary injury while performing laparoscopic cholecystectomy (LC) is an unsolved problem. Clarifying the surgical difficulty using intraoperative findings can greatly contribute to the pursuit of best practices for acute cholecystitis. In this study, multiple evaluators assessed surgical difficulty items in unedited videos and then constructed a proposed surgical difficulty grading. Methods: We previously assembled a library of typical video clips of the intraoperative findings for all LC surgical difficulty items in acute cholecystitis. Fifty-one experts on LC assessed unedited surgical videos. Inter-rater agreement was assessed by Fleiss's κ and Gwet's agreement coefficient (AC). Results: Except for one item (“edematous change”), κ or AC exceeded 0.5, so the typical videos were judged to be applicable. The conceivable surgical difficulty gradings were analyzed. According to the assessment of difficulty factors, we created a surgical difficulty grading system (agreement probability = 0.923, κ = 0.712, 90% CI: 0.587-0.837; AC2 = 0.870, 90% CI: 0.768-0.972). Conclusion: The previously published video clip library and our novel surgical difficulty grading system should serve as a universal objective tool to assess surgical difficulty in LC.",

author = "Koji Asai and Yukio Iwashita and Tetsuji Ohyama and Itaru Endo and Taizo Hibi and Akiko Umezawa and Kenji Suzuki and Manabu Watanabe and Masanao Kurata and Yasuhisa Mori and Masaharu Higashida and Yusuke Kumamoto and Junichi Shindoh and Masahiro Yoshida and Goro Honda and Takeyuki Misawa and Yuta Abe and Yuichi Nagakawa and Naoyuki Toyota and Shigetoshi Yamada and Shinji Norimizu and Naoki Matsumura and Naohiro Sata and Hiroki Sunagawa and Masahiro Ito and Yutaka Takeda and Yoshiharu Nakamura and Toshiki Rikiyama and Ryota Higuchi and Takeshi Gocho and Yuki Homma and Teijiro Hirashita and Hideyuki Kanemoto and Masashi Nozawa and Yusuke Watanabe and Atsushi Kohga and Takehisa Yazawa and Hiroshi Tajima and Shin Nakahira and Tadafumi Asaoka and Ryuji Yoshioka and Junya Fukuzawa and Shuichi Fujioka and Taigo Hata and Hidenori Haruta and Yukio Asano and Ryohei Nomura and Joe Matsumoto and Noriaki Kameyama and Atsushi Miyoshi and Hidejiro Urakami and Yasuji Seyama and Takanori Morikawa and Yoichi Kawano and Hisashi Ikoma and Kin, {Dal Ho Kim} and Tadahiro Takada and Masakazu Yamamoto",

note = "Publisher Copyright: {\textcopyright} 2021 Japanese Society of Hepato-Biliary-Pancreatic Surgery.",

year = "2022",

month = jul,

doi = "10.1002/jhbp.1068",

language = "English",

volume = "29",

pages = "758--767",

journal = "Journal of Hepato-Biliary-Pancreatic Sciences",

issn = "1868-6974",

publisher = "Springer Verlag",

number = "7",

}

Asai, K, Iwashita, Y, Ohyama, T, Endo, I, Hibi, T, Umezawa, A, Suzuki, K, Watanabe, M, Kurata, M, Mori, Y, Higashida, M, Kumamoto, Y, Shindoh, J, Yoshida, M, Honda, G, Misawa, T, Abe, Y, Nagakawa, Y, Toyota, N, Yamada, S, Norimizu, S, Matsumura, N, Sata, N, Sunagawa, H, Ito, M, Takeda, Y, Nakamura, Y, Rikiyama, T, Higuchi, R, Gocho, T, Homma, Y, Hirashita, T, Kanemoto, H, Nozawa, M, Watanabe, Y, Kohga, A, Yazawa, T, Tajima, H, Nakahira, S, Asaoka, T, Yoshioka, R, Fukuzawa, J, Fujioka, S, Hata, T, Haruta, H, Asano, Y, Nomura, R, Matsumoto, J, Kameyama, N, Miyoshi, A, Urakami, H, Seyama, Y, Morikawa, T, Kawano, Y, Ikoma, H, Kin, DHK, Takada, T & Yamamoto, M 2022, 'Application of a novel surgical difficulty grading system during laparoscopic cholecystectomy', Journal of Hepato-Biliary-Pancreatic Sciences, vol. 29, no. 7, pp. 758-767. https://doi.org/10.1002/jhbp.1068

TY - JOUR

T1 - Application of a novel surgical difficulty grading system during laparoscopic cholecystectomy

AU - Asai, Koji

AU - Iwashita, Yukio

AU - Ohyama, Tetsuji

AU - Endo, Itaru

AU - Hibi, Taizo

AU - Umezawa, Akiko

AU - Suzuki, Kenji

AU - Watanabe, Manabu

AU - Kurata, Masanao

AU - Mori, Yasuhisa

AU - Higashida, Masaharu

AU - Kumamoto, Yusuke

AU - Shindoh, Junichi

AU - Yoshida, Masahiro

AU - Honda, Goro

AU - Misawa, Takeyuki

AU - Abe, Yuta

AU - Nagakawa, Yuichi

AU - Toyota, Naoyuki

AU - Yamada, Shigetoshi

AU - Norimizu, Shinji

AU - Matsumura, Naoki

AU - Sata, Naohiro

AU - Sunagawa, Hiroki

AU - Ito, Masahiro

AU - Takeda, Yutaka

AU - Nakamura, Yoshiharu

AU - Rikiyama, Toshiki

AU - Higuchi, Ryota

AU - Gocho, Takeshi

AU - Homma, Yuki

AU - Hirashita, Teijiro

AU - Kanemoto, Hideyuki

AU - Nozawa, Masashi

AU - Watanabe, Yusuke

AU - Kohga, Atsushi

AU - Yazawa, Takehisa

AU - Tajima, Hiroshi

AU - Nakahira, Shin

AU - Asaoka, Tadafumi

AU - Yoshioka, Ryuji

AU - Fukuzawa, Junya

AU - Fujioka, Shuichi

AU - Hata, Taigo

AU - Haruta, Hidenori

AU - Asano, Yukio

AU - Nomura, Ryohei

AU - Matsumoto, Joe

AU - Kameyama, Noriaki

AU - Miyoshi, Atsushi

AU - Urakami, Hidejiro

AU - Seyama, Yasuji

AU - Morikawa, Takanori

AU - Kawano, Yoichi

AU - Ikoma, Hisashi

AU - Kin, Dal Ho Kim

AU - Takada, Tadahiro

AU - Yamamoto, Masakazu

PY - 2022/7

Y1 - 2022/7

N2 - Background: Prevention of bile duct injury and vasculo-biliary injury while performing laparoscopic cholecystectomy (LC) is an unsolved problem. Clarifying the surgical difficulty using intraoperative findings can greatly contribute to the pursuit of best practices for acute cholecystitis. In this study, multiple evaluators assessed surgical difficulty items in unedited videos and then constructed a proposed surgical difficulty grading. Methods: We previously assembled a library of typical video clips of the intraoperative findings for all LC surgical difficulty items in acute cholecystitis. Fifty-one experts on LC assessed unedited surgical videos. Inter-rater agreement was assessed by Fleiss's κ and Gwet's agreement coefficient (AC). Results: Except for one item (“edematous change”), κ or AC exceeded 0.5, so the typical videos were judged to be applicable. The conceivable surgical difficulty gradings were analyzed. According to the assessment of difficulty factors, we created a surgical difficulty grading system (agreement probability = 0.923, κ = 0.712, 90% CI: 0.587-0.837; AC2 = 0.870, 90% CI: 0.768-0.972). Conclusion: The previously published video clip library and our novel surgical difficulty grading system should serve as a universal objective tool to assess surgical difficulty in LC.

AB - Background: Prevention of bile duct injury and vasculo-biliary injury while performing laparoscopic cholecystectomy (LC) is an unsolved problem. Clarifying the surgical difficulty using intraoperative findings can greatly contribute to the pursuit of best practices for acute cholecystitis. In this study, multiple evaluators assessed surgical difficulty items in unedited videos and then constructed a proposed surgical difficulty grading. Methods: We previously assembled a library of typical video clips of the intraoperative findings for all LC surgical difficulty items in acute cholecystitis. Fifty-one experts on LC assessed unedited surgical videos. Inter-rater agreement was assessed by Fleiss's κ and Gwet's agreement coefficient (AC). Results: Except for one item (“edematous change”), κ or AC exceeded 0.5, so the typical videos were judged to be applicable. The conceivable surgical difficulty gradings were analyzed. According to the assessment of difficulty factors, we created a surgical difficulty grading system (agreement probability = 0.923, κ = 0.712, 90% CI: 0.587-0.837; AC2 = 0.870, 90% CI: 0.768-0.972). Conclusion: The previously published video clip library and our novel surgical difficulty grading system should serve as a universal objective tool to assess surgical difficulty in LC.

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U2 - 10.1002/jhbp.1068

DO - 10.1002/jhbp.1068

M3 - Article

C2 - 34748289

AN - SCOPUS:85120567702

SN - 1868-6974

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JO - Journal of Hepato-Biliary-Pancreatic Sciences

JF - Journal of Hepato-Biliary-Pancreatic Sciences

IS - 7

ER -

Application of a novel surgical difficulty grading system during laparoscopic cholecystectomy

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