PD07-09 DEVELOPMENT AND VALIDATION OF AN OBJECTIVE SCORING TOOL FOR MINIMALLY INVASIVE PARTIAL NEPHRECTOMY: SCORING FOR PARTIAL NEPHRECTOMY (SPAN)

摘要

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy I1 Apr 2018PD07-09 DEVELOPMENT AND VALIDATION OF AN OBJECTIVE SCORING TOOL FOR MINIMALLY INVASIVE PARTIAL NEPHRECTOMY: SCORING FOR PARTIAL NEPHRECTOMY (SPAN) Ahmed Aly Hussein, Rooney Abaza, Craig Rogers, Ronald Boris, James Porter, Mohamad Allaf, Ketan Badani, Michael Stifelman, Jihad Kaouk, Tomoaki Terakawa, Youssef Ahmed, Eric Kauffman, Qiang Li, Khurshid Guru, and Daniel Eun Ahmed Aly HusseinAhmed Aly Hussein More articles by this author , Rooney AbazaRooney Abaza More articles by this author , Craig RogersCraig Rogers More articles by this author , Ronald BorisRonald Boris More articles by this author , James PorterJames Porter More articles by this author , Mohamad AllafMohamad Allaf More articles by this author , Ketan BadaniKetan Badani More articles by this author , Michael StifelmanMichael Stifelman More articles by this author , Jihad KaoukJihad Kaouk More articles by this author , Tomoaki TerakawaTomoaki Terakawa More articles by this author , Youssef AhmedYoussef Ahmed More articles by this author , Eric KauffmanEric Kauffman More articles by this author , Qiang LiQiang Li More articles by this author , Khurshid GuruKhurshid Guru More articles by this author , and Daniel EunDaniel Eun More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.442AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES There is lack of objective and procedure-specific tools for comprehensive assessment of minimally invasive partial nephrectomy. We aimed to develop and validate a structured scoring tool: Scoring for Partial Nephrectomy (SPaN). METHODS A national expert panel of 10 robotic surgeons contributed towards development and content validation of SPaN. The critical steps of partial nephrectomy were deconstructed into 7 key domains, where each domain was assessed by 5 anchors evaluating surgical principles, technical proficiency and safety. Delphi methodology was utilized to validate the content of SPaN. Each anchor statement was assessed in terms of relevance, concordance of language used and the assigned anchor score, and clarity of the wording used. An independent coordinator collected the scores, together with the comments from the expert panel and calculated the Content Validity Index (CVI) for each aspect of each anchor. Consensus was achieved for a certain statement if CVI was ≥0.75, and this statement was removed from the next round. If CVI < 0.75, the coordinator incorporated the comments from the panel, updated the scoring and redistributed it again to the panel. This process was repeated until consensus was achieved for all statements. All experts were blinded to each other's assessment to minimize "bandwagon" effect. The reliability and construct validation of SPaN were also statistically assessed. RESULTS The expert panel reached consensus after 2 rounds on all aspects. Domain 7 for ischemia time was combined with renorrhaphy based on the panel consensus. CVI ≥0.75 was achieved in 36 (67%) statements in the first round while the consensus for the remaining 18 statements was achieved after the second round. The final six domains of SPaN are: Exposure of the Kidney, Identification and Dissection of the Ureter and Gonadal vessels, Dissection of the Hilum, Tumor Localization and Exposure, Clamping and Tumor Resection, and Renorrhaphy (Figure 1). Acceptable reliability and construct validation were achieved. CONCLUSIONS We developed and validated a scoring system for minimally invasive partial nephrectomy that can provide structured and objective feedback for assessment of technical skills during minimally invasive partial nephrectomy. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e159-e160 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Ahmed Aly Hussein More articles by th