MW16 Laparoscopic Suture Simulator-Assessment SystemProduct Supervision
Makoto Hashizume, Professor, Center for Advanced Medical Innovation,Kyushu University, Japan
Munenori Uemura, PhD Professor (Assistant),
Center for Advanced Medical Innovation, Kyushu University, Japan

Laparoscopic Suture Simulator -Assessment System-

Objective assessment of intestinal tract suture and skin suture.
Traineesʼ personal skills assessment data can be saved for reviewing and analysis.

MW16 Laparoscopic Suture Simulator
Assessment System

Useful for training laparoscopic intestinal suture, Skin
suture, and Handling of laparoscopic instrumentstraining

Innovative assessment criteria and quantitative
measurement provide objective feedback to trainers.

Life-like four-layer intestinal track

Assessment Criteria

Life-like four-layer intestinal tract*The criteria are based upon the cooperation
by certified physician of Japan Society of Laparoscopic Surgery

Intestinal tract has four layers with respective characteristics.
When holding with forceps and suturing, these four layers react
like real tissue.

Success

Is the wound sutured without leakage?
Is suture completed from muscular layer
through mucosal layer?

Serosa Layer
Muscular Layer

Submucosal Layer
Mucosal Layer

Is ligature force appropriate for suture?
How much open area are there in the mucosal layer?
How long does it take for suturing procedure?

In order to assess Success or Failure, leakage test by checking the leaked air from the suturing area is carried out.

■ Prize

2nd Place Technology Innovation ‒ IMSH2014
Munenori Uemura, Makoto Yamashita, Morisasa Tomikawa, Satoshi Leiri, Noriyuki Mastsuoka, Tomotsu Katayama and Makoto Hashizume“A New Objective Assessment System of Suture Ligature Method of the Intestinal Anastomosis Model for Laparoscopic Surgery”■ Papers
Munenori Uemura , Makoto Yamashita, Morimasa Tomikawa, Satoshi Obata, Ryota Souzaki , Satoshi Ieiri, Kenoki Ohuchida,Noriyuki Matsuoka, Tamotsu Katayama, Makoto Hashizume“Objective assessment of the suture ligature method for the laparoscopic intestinal anastomosis model using a newcomputerized system” Surgical Endoscopy DOI 10.1007/s00464-014-3681-9

MW16 Laparoscopic Suture Simulator Assessment System
Cycles of practice and assessment are the keys for improvement

NEWS

MW16 Laparoscopic Suture Simulator Assessment System was officially adopted insuture and ligature session by Japan Society for Endoscopic Surgeon in 2016.
The session is for medical doctors who seeks technical certificate as endoscopicsurgery.
2016/07/20

MW16 Laparoscopic Suture Simulator Assessment System
Cycles of practice and assessment are the keys for improvement-As part of Clinical Clerkship for 6th year students of medical school
Ten 6th year students of Kansai Medical University gathered in the simulation center.
Dr. Inoue, associate professor told their students to start training. First, students experienced the laparoscopic senses of touch using dry boxes.
After they became confident with their skills to some extent, the assessment using MW16 Simulator started.

This hands-on training indicated that even when there are lots ofstudents attending in the class, effective training is possible. Motivationof some students got higher by getting assessment from the MW16simulator.

“I would like students to learn no matter which clinical department toproceed, the important thing is to practice many times until reaching thegoals” Dr. Inoue saidＮＯＴＥ
Simulator used in this class● MW16 Laparoscopic Suture Simulator Assessment System● MCM-1 Dry box (End Work Pro II)

Interview after using MW16 simulators for medical school students
Dr. Kentaro Inoue, Surgeon, Associate Professor of Kansai Medical University.
Certified physician of Japan Society for Endoscopic Surgeon.

In traditional laparoscopic training, the points that could beassessed were “time” and “liquid leakage when water is put into
the intestinal tract”. The MW16 simulator helps me teach students
more effectively, and studentʼs reaction to this course was great.
Not only can physician pursue the “quality” of their procedures, butalso they can set clear goal and get satisfaction after reaching it.
The MW16 simulator also helps students advance to the learningfrom simply “seeing” the expertʼs procedure to the hands-on
training which can help them understand the interesting anddifficult point of laparoscopy. In short, the MW16 enhances
multilateral learning.

③④⑤● Numbers of training sessions: Four in total (May 25th, June 1st, June 22nd, June 29th)● Students: 19 students (6th year of medical school), 2 residents● Average number of assessment: 6 times● Result: Significant difference were confirmed in air leakage (kPa) and total score(20 points for full score) of the first, and the last training session.
Average Score

141312111098First

Last

Feedbacks fromStudents

At the end of the training, we madequestionnaires to the participants ofthis session.
-My motivation got higher by receiving
score from the MW16 simulator-The sense of touch of MW16 simulator
was much clearer than virtual reality
simulators.
-I could recognize my weak points.
-It was fun to train with simulators whichhave objective assessment criteria.

12.9
11.1

Leakage(kPa)

14.7
14.7

Average Leakage (kPa)P < 0.05

15Score①Assessment using MW16Simulator②Visual check by Dr. Inoue③Dry box training④Training overview⑤Demonstration by Dr. Inoue
First

While training using the MW16 simulator, students commented;“My score in suture tension was good, but the opening area was too large so there were too much leakage. I would like to try once more and modify
the opening area”“It took me much time to suture, but I could achieve three full-thickness suture! My score got better than last time”
Every time students get feedback from the MW16 simulator, they learned from it and their score improved.

Data Analysis②FinalBefore the hands-on training, students took introductory courses about skin suture and the ways to handle forceps. The students learned a lot fromthe courses, so the hands-on training went on smoothly.

①P < 0.05

161412108
64
20TimeLastLeakage

First

Last

Suture tension

Full-thickness suture

ＣＯＬＵＭＮ
After
thelaparoscopic
suture training session.
"CutPaper"sessionstarted. Groups of twostudents prepared various
kind of Origami.
Design pattern book and albums which past students made on
the table. Using scissor forceps, students cut Origami and madegeometric patterns.
Teamwork and role divisions are necessary to choose good
designs in dry box. Students struggled but had fun.
We found out through the session that the teacherʼs creativity
and ingenuity are important factors to help students learn
effectively.

Opening area

Student's work→