5 Assessment Points of MW16 Simulator
based upon statistical evidences

1. Is the wound sutured without leakage?
2. Is suture completed from muscular layer
through mucosal layer?
3. Is ligature force appropriate for suture?
4. How much open area are there in the mucosallayer?
5. How long does it take for suturing procedure?

Four-layer structures of intestinal tract
sheet which react like real tissue
Serosa Layer
MuscularLayer

Mucosal Layer
Submucosal Layer

Each layer has different levels of flexibilities,
which react similarly to human bodies
when holding by forceps and suturing＋αLaparoscopic Suture
Training Box

MCM-1 End-Work Pro II

Assessment data
based upon
experiment datafrom novices andexperts

3 Types of Training Possible in MW16 Simulator

The compact training box (End Work Pro II)
allows multiple times of suture training-The high resolution CCDcamera allows clear
operating field.

Intestinal tract
suture underlaparoscopy

MW16 11395-000
Laparoscopic Suture Simulator-Assessment System-

Assessment ofskin suture

Forceps training

MW16 Laparoscopic Suture Simulator-Assessment SystemSpecification
Size ：W50xD110xH160cm
Weight ：93kgPower Supply：AC100-240V 50/60HzPower Consumption：180VA-Eight working fields andthe adjustment of heightmake possible various
modes of surgicalprocedural trainings.

http://www.kyotokagaku.com
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Head Office
15 Kitanekoya-cho Fushimi-ku Kyoto, Japan 612-8388
Telephone : +81-75-605-2510 Fax:+81-75-605-2519
Email : rw-kyoto@kyotokagaku.co.jp
Hong Kong Office
Kyoto Kagaku Co., Ltd Hong Kong Representative Office
Level 60, One Island East, 18 Westlands Road, Island East,Hong Kong
Telephone : 852-3978-1365 Fax : 852-3978-1199■ Interview 2■ Interview 1

Dr. Kazushi Ito

Dr. Koya Hida

Center for Medical
Education and Training,
Kyoto University HospitalCenter for Medical
Education and Training,digestive surgeon,
Kyoto University Hospital

Laparoscopic surgery have become remarkably
widespread due to its advantage in the visual sense. In
order to conduct procedures safely, acquisition of basic
procedural skills is necessary. Hands-on training using
simulators is one of the most effective ways to train
laparoscopic suture and ligature skills. Simulator allows
medical doctors to get used to the 2D video monitor
views in laparoscopy and coordinated movements ofvision and forceps. The MW16 simulator assess thedoctorʼs performance of suture and ligature withobjective evaluation scales. With the MW16 simulator,
learners can repeatedly recognize their problems andreflect them to their patients.

We held a contest using MW16 simulator. The best
part of this contest is to enhance interaction between
doctors from various clinical departments. This time,
medical advisors,
medicalstaffsandresidents
from endocrinology, OB&GYN, and various fields ofsurgery worked on the intestinal suture tract sutureseriously yet in peaceful mood. In actual suture,minimizing leakage is possible by suturing in highdensity. However, the MW16 simulator asks doctors tosuture 3 stitches in a short period of time, which isinteresting as a game. Not only can doctors check theirown suture, but also measure the leakage, which isfascinating for learners. I would like to provide further
learning opportunities that the doctors can enjoy
learning.

Associate professor

Lecturer

D E V E L O P

S K I L L S

Objective Assessment for Better TrainingStep 2

Laparoscopic Suture Training Using MW16Assessment System- Case introduction from Kyoto University Hospital -apa

鏡縫合Laparoscング

Training

The following contest-style training takes about two hours-The actual training proceeds smoothly if the rule is introduced to the learners
before the contest. (If you could know the list of participants in advance, you canalso decide the teams and announce them)

Advance notice*What kind of rules necessary for contest?
In order to maintain feelings of tension, time limit (about 15min/person) and theneedles in one time should be decided.

Contest-style Session Utilizing MW 16 Assessment System
Step 1

Demonstration

Preparing necessary items

15minThings to prepare

Table

Contest using the MW16 Simulator-Members should decide the turns and start using MW16simulator
Here are few example of rules:-Three simple knotted suture-15 minutes time limit-Limitation of the number of needles.

-MW16 Laparoscopic suture simulator
assessment system.
-Training box-Monitor for training box
Things to prepare in tables
Table

Table

MW16Simulator
Training Box-Forceps: Two grasping forceps and one scissors forceps-Suturing string with needles-Intestinal sheet as part of the MW16 simulator-Boxes to put needles for disposal-Timer for training box

Contest90
min

20 learners in two hours. Please adjust the numbers ofsimulators depending upon the number of learners.

Utilizingfeedbacsimulat
ks fromorMW16

As MW16 simulator assess
doctorʼs skill based on the datataken from novices and experts, it
helps doctors to reflect theirprocedural skills based upon theobjective data. The five feedback
criteria allow doctors to modify
their weak point, and improve tohigher levels.

Design enjoyable training

This training was held in conteststyle. Remember to build achallenging, but fun atmospherethroughout the contest.

In this training, top scorers weredisplayed in a big screen (without
showing their names), andceremony was held after thecontest.

Tag-team should be madebetween different levels

If residents are included in theparticipants, coaching inside groupis possible by making tag-team
between different levels ofparticipants. The learners candeepen their understanding while
the teacher can practice how toteach.
If the session is held in conteststyle. The top-scorer can bepresented separately by the level ofparticipants.

Review

Announcementof results

Vacant time

Recognizing skills by
objective assessment

Use of training boxes by vacant participants-When other participants are using MW16
simulator, the vacant participants can use thetraining boxes on the side and deepen theirunderstandings by practicing.
Even when the number of participants are high:-The assessment by MW16 simulator can bepossible afterwards when you have the record
about intestinal tract sheet and time. By suturing
the intestinal tract sheet in training box andmeasuring the time, you can use them as records ofthe contest.

Layout

How to design training courses

Explanation should be done about the rules, groups and the assessment points
in MW16 simulator.
Coordinator should demonstrate how to use the MW16 Simulator.

Review in free time:-The participants can review their procedures based upon
the assessment and try once again.
-Using their own training sheet, the participants
can take time for training bearing in mind theirweak point.
Supervision of senior trainees to juniors;
In case there are senior and junior trainees in one team, the supervision of senior trainees candeepen understanding of both the senior and the junior.

Announcement of top scorers/ sharing of their know-how

5min-The top-scorer and the assessment sheet, and the things the top-scorer kept in mind
should be shared.
-Based on the assessment data, the participants should set their next goal and keep theirtraining.