Correlation between forceps grasp count and skill proficiency in single-incision laparoscopic percutaneous extraperitoneal closure: A retrospective single-center study.

Introduction: This study aimed to investigate the correlation between forceps grasp count and procedure time in single-incision laparoscopic percutaneous extraperitoneal closure surgeries and the evolution of these metrics with accumulated experience.

Methods: We retrospectively reviewed 741 procedures performed by surgeons between 2015 and 2023. Surgical videos were analyzed to calculate the procedure time, defined as the time required for suturing around the hernial orifice, and the forceps grasp count. Correlations were evaluated using Spearman's rank correlation coefficients. Changes in experience were assessed using linear regression.

Results: Surgeons demonstrated a significantly longer procedure time (585 s vs. 437 s, p < .001) and higher grasp counts (22 times vs. 17 times, p < .001) for surgeries performed on male patients than on female patients. Grasp count was strongly correlated with procedure time (male patients: r = .800; female patients: r = .758, p < .001). With accumulated experience, both procedure time and grasp count decreased, although novice surgeons showed delayed improvement in forceps manipulation compared with improvement in procedure time.

Conclusion: Grasp count was strongly correlated with procedure time in single-incision laparoscopic percutaneous extraperitoneal closure. Accumulated experience improved both metrics, with novice surgeons possibly requiring more time to acquire efficient forceps manipulation skills. Efficient forceps manipulation is a valuable metric for evaluating surgical skills.