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Purpose <p>To examine whether Japanese Society of Pediatric Surgeons (JSPS) supervisory certification is associated with intraoperative directive communication patterns, potentially explaining the previously observed shorter manipulation times in pediatric single-incision laparoscopic percutaneous extraperitoneal closure (SILPEC).</p> Methods <p>We conducted a single-center, audio-based observational study focusing on male patients who underwent SILPEC between December 2024 and September 2025. Attending-to-operator statements during hernial suturing were transcribed and coded. Directive statements (commanding/advising) were counted per minute and compared between the groups. A multivariate linear regression analysis with cluster-robust standard errors for the attending surgeons was performed to identify the factors associated with directive statement frequency.</p> Results <p>Forty procedures were performed in total. Directive frequency was higher in the certified group (median, 1.3 vs. 0.59 per minute). A multivariate analysis revealed that supervisory certification increased directive frequency (B = 0.69; 95% confidence interval [CI], 0.60–0.77), while the operating surgeon’s postgraduate year decreased it (B = − 0.22; 95% CI, − 0.31 to − 0.12). A history of hernia incarceration was also negatively associated with directive frequency (B = − 0.62; 95% CI, − 1.12 to − 0.12).</p> Conclusions <p>JSPS-certified supervisors delivered directive statements more frequently, whereas guidance decreased with operator seniority and incarceration. These exploratory findings require validation through further studies involving a larger cohort of certified supervisors.</p>

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Audio-based analysis of directive verbal guidance in pediatric single-incision laparoscopic percutaneous extraperitoneal closure: the impact of supervisory certification and operating surgeon seniority

  • 期刊论文

  • 发表日期：

    2026年2月13日

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  • Yohei Sanmoto,
  • Masanaga Matsumoto,
  • Mikihiro Inoue,
  • Akio Kawami,
  • Kouji Masumoto

摘要

Purpose

To examine whether Japanese Society of Pediatric Surgeons (JSPS) supervisory certification is associated with intraoperative directive communication patterns, potentially explaining the previously observed shorter manipulation times in pediatric single-incision laparoscopic percutaneous extraperitoneal closure (SILPEC).

Methods

We conducted a single-center, audio-based observational study focusing on male patients who underwent SILPEC between December 2024 and September 2025. Attending-to-operator statements during hernial suturing were transcribed and coded. Directive statements (commanding/advising) were counted per minute and compared between the groups. A multivariate linear regression analysis with cluster-robust standard errors for the attending surgeons was performed to identify the factors associated with directive statement frequency.

Results

Forty procedures were performed in total. Directive frequency was higher in the certified group (median, 1.3 vs. 0.59 per minute). A multivariate analysis revealed that supervisory certification increased directive frequency (B = 0.69; 95% confidence interval [CI], 0.60–0.77), while the operating surgeon’s postgraduate year decreased it (B = − 0.22; 95% CI, − 0.31 to − 0.12). A history of hernia incarceration was also negatively associated with directive frequency (B = − 0.62; 95% CI, − 1.12 to − 0.12).

Conclusions

JSPS-certified supervisors delivered directive statements more frequently, whereas guidance decreased with operator seniority and incarceration. These exploratory findings require validation through further studies involving a larger cohort of certified supervisors.