Table 2.

Van Sickle assessment ¹¹ of suture errors used for video assessment

Error	Description
Missed grasp	Jaws of the instrument are opened and closed without retaining the desired target (either suture, tissue or needle)
Instrument not assisting	The instrument not holding the suture is not actively engaged in assisting in the performance of the step or is out of view while not actively participating in the procedure (holding exposure, holding the suture)
Tear/injure tissue	Tearing tissue with either manipulation or retraction, a placed suture tearing through the tissue, or tissue injury that causes bleeding from contact with the needle
Excessive manipulation	Either the needle or the suture is grasped more than two times during a step. The contact of the grasper with the suture to slide the knot down does not count
Incomplete or repeated bite	Once the tip of the suture needle engages the target tissue, it is either disengaged or fails to traverse the tissue completely (the tip is not seen, or once seen does not remain visible) without additional manipulation
Needle out of view	A grasped needle is completely out of view. Grasped suture with a hanging needle does not count. If the needle is out of view due to a primary scope problem then an error is not scored
Missed loop	Once an attempt to loop the suture around the instrument is initiated, it is not completed
Tail looped	When the suture tail is pulled through to make a knot, it loops and requires a release and additional manipulation to free the loop
Failure to square knot	Once the slipknot is in place, it is not squared
Attending takeover	The attending surgeon has to demonstrate or perform any aspect of suturing or tying
Scissors touch tissue	The non‐shaft portion of the scissors touches tissue