Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2025 Mar 22;29(1):82.
doi: 10.1007/s10151-025-03121-7.

Vascular pedicle dissection time in laparoscopic colectomies as a novel marker of surgical skill: a prospective cohort study

Kirsten de Burlet  1 , Isaac Tranter-Entwistle  2 , Jeffrey Tan  3 , Anthony Lin  3 , Siraj Rajaratnam  4 , Saxon Connor  2 , Timothy Eglinton  2
Affiliations
Multicenter Study

Vascular pedicle dissection time in laparoscopic colectomies as a novel marker of surgical skill: a prospective cohort study

Kirsten de Burlet et al. Tech Coloproctol. .

Abstract

Background: Outcomes after colorectal resections depend on patient, pathology and operative factors. Existing validated surgical skills scores (such as the competency assessment tool (CAT)) are directly correlated with outcomes but are time-consuming to administer, limiting their clinical utility. The vascular pedicle dissection time (VPDT) is a novel, simple surgical skill assessment measure with the potential for computer vision automation. This study aimed to assess the VPDT and benchmark it against the CAT score.

Methods: A prospective multicentre study was performed in New Zealand, recording videos of laparoscopic colorectal resections. Patient, operation and histology characteristics were also collected. The VPDT was calculated from retraction of the vascular pedicle to completion of medial dissection, including vascular division. Each laparoscopic video was scored by two independent colorectal surgeons, and the median CAT score was grouped into tertiles.

Results: In total, 154 patients were included between December 2020 and November 2023 (74 (48.1%) right-sided and 80 (51.9%) left-sided resections). Median VPDT was significantly different between the CAT score groups for the right-sided resections (lower, 15 min; middle, 13 min; higher, 10 min; p = 0.036) and the left-sided resections (lower, 46 min; middle, 40 min; higher, 26 min; p = < 0.001). There was no significant difference in R1 resection, anastomotic leak rate, the occurrence of Clavien-Dindo > 3 complications or re-admission between the CAT groups.

Conclusions: This study showed that the VPDT was inversely correlated with the CAT score, indicating that it quantifies operative technical skill. A current study is evaluating the suitability of VPDT for real-time measurement using computer vision algorithms. This could allow for automated assessment of surgeons' learning curve and skills.

Keywords: Colorectal surgery; Competency assessment tool; Laparoscopic surgery; Surgical skills; Textbook outcome.

PubMed Disclaimer

Conflict of interest statement

Declarations. Conflicts of interest: Kirsten de Burlet, Isaac Tranter-Entwistle, Jeffrey Tan, Anthony Lin, Siraj Rajaratnam, Saxon Connor and Timothy Eglinton have no conflicts of interest or financial ties to disclose.

Figures

Fig. 1
Fig. 1
Flowchart study inclusion and exclusion
Fig. 2
Fig. 2
Median VPDT times (in minutes) divided into tertiles for patients who underwent a right hemicolectomy
Fig. 3
Fig. 3
Median VPDT times (in minutes) divided into tertiles for patients who underwent an anterior resection
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Siegel RL, Miller KD, Fuchs HE, Jemal A (2021) Cancer statistics 2021. CA: A Cancer J Clin. 71:7–33 - PubMed
    1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer J Clin. 68:394–424 - PubMed
    1. Kasi A, Abbasi S, Handa S, Al-Rajabi R, Saeed A, Baranda J, Sun W (2020) Total neoadjuvant therapy vs standard therapy in locally advanced rectal cancer: a systematic review and meta-analysis. JAMA Netw Open 3:e2030097 - PMC - PubMed
    1. Liu S, Jiang T, Xiao L, Yang S, Liu Q, Gao Y, Chen G, Xiao W (2021) Total neoadjuvant therapy (TNT) versus standard neoadjuvant chemoradiotherapy for locally advanced rectal cancer: a systematic review and meta-analysis. Oncologist 26:e1555–e1566 - PMC - PubMed
    1. Cercek A, Lumish M, Sinopoli J, Weiss J, Shia J, Lamendola-Essel M, El Dika IH, Segal N, Shcherba M, Sugarman R, Stadler Z, Yaeger R, Smith JJ, Rousseau B, Argiles G, Patel M, Desai A, Saltz LB, Widmar M, Iyer K, Zhang J, Gianino N, Crane C, Romesser PB, Pappou EP, Paty P, Garcia-Aguilar J, Gonen M, Gollub M, Weiser MR, Schalper KA, Diaz LA Jr (2022) PD-1 blockade in mismatch repair-deficient, locally advanced rectal cancer. N Engl J Med 386:2363–2376 - PMC - PubMed

Publication types

LinkOut - more resources