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Eurboonyanun C, Aphinives P, Wittayapairoch J, Eurboonyanun K, Srisuk T, Punchai S, Ruangwannasak S, Jenwitheesuk K, Petrusa E, Gee D, Phitayakorn R. Trend of minimally invasive and open surgery experience of general surgery residents: Accreditation Council for Graduate Medical Education general surgery case log in Thailand. JOURNAL OF MINIMALLY INVASIVE SURGERY 2023; 26:121-127. [PMID: 37712311 PMCID: PMC10505362 DOI: 10.7602/jmis.2023.26.3.121] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/17/2023] [Accepted: 09/06/2023] [Indexed: 09/16/2023]
Abstract
Purpose Minimally invasive surgery (MIS) offers patients several benefits, such as smaller incisions, and fast recovery times. General surgery residents should be trained in both open and MIS. We aimed to examine the trends of minimally invasive and open procedures performed by general surgery residents in Thailand. Methods A retrospective review of the Royal College of Surgeons of Thailand and Accreditation Council for Graduate Medical Education general surgery case logs from 2007 to 2018 was performed for common open and laparoscopic general surgery operations. The data were grouped by three time periods, which were 2007-2010, 2011-2014, and 2015-2018, and analyzed to explore changes in the operative trends. Results For Thai residents, the mean number of laparoscopic operations per person per year increased from 5.97 to 9.36 (56.78% increase) and open increased from 20.02 to 27.16 (35.67% increase). There was a significant increase in the average number of minimally invasive procedures performed among cholecystectomy (5.83, 6.57, 8.10; p < 0.001) and inguinal hernia repair (0.33, 0.35, 0.66; p < 0.001). Compared to general surgery residents in the United States, Thai residents had more experience with open appendectomy, but significantly less experience with all other operations/procedures. Conclusion The number of open and minimally invasive procedures performed or assisted by Thai general surgery residents has slowly increased, but generally lags behind residents in the United States. The Thai education program must be updated to improve residents' technical skills in open and laparoscopic surgery to remain competitive with their global partners.
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Affiliation(s)
- Chalerm Eurboonyanun
- Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- Department of Surgery, The Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Potchavit Aphinives
- Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | | | - Kulyada Eurboonyanun
- Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Tharatip Srisuk
- Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Suriya Punchai
- Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Somchai Ruangwannasak
- Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | | | - Emil Petrusa
- Department of Surgery, The Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Denise Gee
- Department of Surgery, The Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Roy Phitayakorn
- Department of Surgery, The Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Continuum of Surgical Skill Acquisition for the Postgraduate Residents During COVID Pandemic: Role of Advanced Simulators in a Multipronged Modular Approach. Indian J Surg Oncol 2021; 12:270-278. [PMID: 34776711 PMCID: PMC8576460 DOI: 10.1007/s13193-021-01472-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 10/29/2021] [Indexed: 11/04/2022] Open
Abstract
Skill acquisition with required competencies as defined by the National Medical Commission for the postgraduate surgical residents can happen in a step-wise manner from novice or advanced beginner to competent levels. This requires well-defined program-specific objectives, teaching-learning and assessment methods as per the competency-based medical education curriculum. Various modalities of teaching for the residents are adapted during the COVID pandemic to maintain the continuum of learning. In this study, we have attempted to develop, implement, and evaluate the effectiveness of acquiring laparoscopic surgical skills using advanced simulators and with large live animal in a real-life situation by a modular training approach. This skill-based program was developed and implemented for final year General Surgery postgraduate residents of Yenepoya Medical College for training laparoscopic surgical competencies. The training was conducted at Advanced Simulation Centres of Yenepoya (Deemed to be University), Mangalore, Karnataka, India. Three training modules were prepared based on the competency-based medical education curriculum for incremental training with advanced simulators and large live animals in a real-life situation which included the sessions on briefing, scenarios, simulations, hands-on activities, debriefing, feedback, and assessment methods. Assessment after the modular training showed statistically significant improvement in their scores, and they scaled up their skill acquisition ladder after each module. The residents and faculty felt that integration from different specialties has increased their confidence levels and communication skills, exploring team dynamics with 1:1 mentorship to make them competent emphasizing the effectiveness of simulation-based training even during the pandemic.
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Sadava EE, Novitsky YW. Simulation in Hernia Surgery: Where Do We Stand? J Laparoendosc Adv Surg Tech A 2021; 31:551-555. [PMID: 33691482 DOI: 10.1089/lap.2021.0081] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Simulation seems to be the best method of improving medical attitude, technical skills, and operating times. A literature review of the available data in simulation for hernia surgery was performed. Surgical simulation has been included as a main requirement in residency programs and endorsed by several surgical societies. However, evaluating how simulation affects patient's outcomes is challenging. In addition, simulation training represents an institutional economic burden that could undermine its implementation and development. Published data support that simulation-based training is a highly efficient tool, thus, its implementation should be strongly encouraged.
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Affiliation(s)
- Emmanuel E Sadava
- Division of Abdominal Wall Surgery, Department of Surgery, Hospital Alemán of Buenos Aires, Buenos Aires, Argentina
| | - Yuri W Novitsky
- Comprehensive Hernia Center, Columbia University Medical Center, New York, New York, USA
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Transferability of Simulation-Based Training in Laparoscopic Surgeries: A Systematic Review. Minim Invasive Surg 2020; 2020:5879485. [PMID: 32908700 PMCID: PMC7468652 DOI: 10.1155/2020/5879485] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 08/01/2020] [Accepted: 08/07/2020] [Indexed: 01/22/2023] Open
Abstract
Objective The implementation of simulation-based training in residency programs has been increased, but the transferability of surgical skills in the real operating room is not well documented. In our survey, the role of simulation in surgical training will be evaluated. Study Design. In this systemic review, randomized control trials, which assessed the transferability of acquired skills through simulation in the real operating setting, were included. A systematic search strategy was undertaken using a predetermined protocol. Results Eighteen randomized clinical trials were included in this survey. Two studies investigated inguinal hernia repair, six laparoscopic cholecystectomy, five gynecologic procedures, two laparoscopic suturing, and two camera navigation during laparoscopic procedures. Simulation-trained participants showed superiority in surgical performance in comparison with untrained surgeons. The operation time, accuracy, incidence of intraoperative errors, and postoperative complications were statistically better in the simulation-trained group in comparison with the conventional-trained group. Conclusion Simulation provides a safe, effective, and ethical way for residents to acquire surgical skills before entering the operating room.
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Raison N, Gavazzi A, Abe T, Ahmed K, Dasgupta P. Virtually Competent: A Comparative Analysis of Virtual Reality and Dry-Lab Robotic Simulation Training. J Endourol 2020; 34:379-384. [DOI: 10.1089/end.2019.0541] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Nicholas Raison
- Division of Transplantation Immunology and Mucosal Biology, Faculty of Life Sciences and Medicine, MRC Centre for Transplantation, King's College London, London, United Kingdom
| | - Andrea Gavazzi
- Department of Urology, Azienda Usl Toscana Centro, Florence, Italy
| | - Takashige Abe
- Division of Transplantation Immunology and Mucosal Biology, Faculty of Life Sciences and Medicine, MRC Centre for Transplantation, King's College London, London, United Kingdom
- Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Kamran Ahmed
- Division of Transplantation Immunology and Mucosal Biology, Faculty of Life Sciences and Medicine, MRC Centre for Transplantation, King's College London, London, United Kingdom
| | - Prokar Dasgupta
- Division of Transplantation Immunology and Mucosal Biology, Faculty of Life Sciences and Medicine, MRC Centre for Transplantation, King's College London, London, United Kingdom
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Lee GI, Lee MR. Can a virtual reality surgical simulation training provide a self-driven and mentor-free skills learning? Investigation of the practical influence of the performance metrics from the virtual reality robotic surgery simulator on the skill learning and associated cognitive workloads. Surg Endosc 2017. [DOI: 10.1007/s00464-017-5634-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mahmoudi A, Noomen F, Nasr M, Zouari K, Hamdi A. [Evaluation of residency training in general and digestive surgery in Tunisia]. Pan Afr Med J 2015; 21:328. [PMID: 26587174 PMCID: PMC4633808 DOI: 10.11604/pamj.2015.21.328.6604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 08/17/2015] [Indexed: 11/15/2022] Open
Abstract
Introduction De nombreux moyens sont mis à disposition des résidents en chirurgie générale et digestive pour assurer leur formation théorique et pratique. Cependant, le niveau d'utilisation de ces différents outils et leur impact sur la formation des résidents n'ont jamais été évalués. L'objectif de notre étude était d’étudier l’état des lieux des moyens de formation utilisés par les résidents pour évaluer leurs degrés de satisfaction et leurs propositions en vue d'améliorer leur formation. Méthodes Un questionnaire anonyme a été distribué aux résidents de chirurgie générale et digestive de l'année 2012-2013. Ce questionnaire portait sur les caractéristiques démographiques, les ressources pédagogiques, ainsi que le cursus médical et universitaire. Une évaluation de la formation ainsi qu'un recueil des propositions faites en vue d'améliorer leurs formations étaient réalisées. Résultats Cinquante résidents sur 83 ont répondu au questionnaire. L'orientation de carrière la plus fréquente était l'hospitalo-universitaire dans 70% des cas. La pratique quotidienne et l'internet étaient les deux ressources pédagogiques les plus utilisées. La formation chirurgicale était jugée satisfaisante par seulement 10% des répondants. Parmi l'ensemble des propositions faites, l'apprentissage sur simulateur chirurgical, l'existence d'un ouvrage national de référence, et l'institution d'un tutorat par un chirurgien senior recueillaient plus de 80% d'avis favorable. Conclusion La majorité des résidents jugent leur formation non satisfaisante. Une meilleure information sur les ressources déjà existantes, un renforcement du compagnonnage et un accès plus large à un apprentissage sur simulateur chirurgical permettraient de diminuer ce sentiment d'insatisfaction.
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Affiliation(s)
- Ammar Mahmoudi
- Service de Chirurgie Générale et Digestive, CHU Fattouma Bourguiba de Monastir, Tunisie
| | - Faouzi Noomen
- Service de Chirurgie Générale et Digestive, CHU Fattouma Bourguiba de Monastir, Tunisie
| | - Mohamed Nasr
- Service de Chirurgie Générale et Digestive, CHU Fattouma Bourguiba de Monastir, Tunisie
| | - Khadija Zouari
- Service de Chirurgie Générale et Digestive, CHU Fattouma Bourguiba de Monastir, Tunisie
| | - Abdelaziz Hamdi
- Service de Chirurgie Générale et Digestive, CHU Fattouma Bourguiba de Monastir, Tunisie
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Shore EM, Lefebvre GG, Grantcharov TP. Gynecology resident laparoscopy training: present and future. Am J Obstet Gynecol 2015; 212:298-301, 298.e1. [PMID: 25068561 DOI: 10.1016/j.ajog.2014.07.039] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 07/18/2014] [Accepted: 07/22/2014] [Indexed: 01/09/2023]
Abstract
Simulator education is essential to surgical training and it should be a requirement at all training programs across North America. Yet, in a survey of North American obstetrics and gynecology program directors (response rate 52%), we found that while 73% (n = 98) of programs teach laparoscopic skills, only 59% (n = 81) were satisfied with their curriculum. Most programs lacked standard setting in the form of theoretical examinations (94%, n = 127) or skills assessments (91%, n = 123) prior to residents performing surgery on patients in the operating room. Most programs (97%, n = 131) were interested in standardizing laparoscopy education by implementing a common curriculum. We present 3 core recommendations to ensure that gynecologists across North America are receiving adequate training in gynecologic laparoscopic surgery as residents: (1) uniform simulator education should be implemented at all training programs across North American residency programs; (2) a standardized curriculum should be developed using evidence-based techniques; and (3) standardized assessments should take place prior to operating room performance and specialty certification. Future collaborative research initiatives should focus on establishing the content of a standardized laparoscopy curriculum for gynecology residents utilizing a consensus method approach.
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Affiliation(s)
- Eliane M Shore
- Department of Obstetrics and Gynecology, St Michael's Hospital and University of Toronto, Toronto, Ontario, Canada.
| | - Guylaine G Lefebvre
- Department of Obstetrics and Gynecology, St Michael's Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Teodor P Grantcharov
- Department of Surgery, St Michael's Hospital and University of Toronto, Toronto, Ontario, Canada
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Shetty S, Zevin B, Grantcharov TP, Roberts KE, Duffy AJ. Perceptions, training experiences, and preferences of surgical residents toward laparoscopic simulation training: a resident survey. JOURNAL OF SURGICAL EDUCATION 2014; 71:727-733. [PMID: 24794063 DOI: 10.1016/j.jsurg.2014.01.006] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Accepted: 01/11/2014] [Indexed: 06/03/2023]
Abstract
INTRODUCTION Simulation training for surgical residents can shorten learning curves, improve technical skills, and expedite competency. Several studies have shown that skills learned in the simulated environment are transferable to the operating room. Residency programs are trying to incorporate simulation into the resident training curriculum to supplement the hands-on experience gained in the operating room. Despite the availability and proven utility of surgical simulators and simulation laboratories, they are still widely underutilized by surgical trainees. Studies have shown that voluntary use leads to minimal participation in a training curriculum. Although there are several simulation tools, there is no clear evidence of the superiority of one tool over the other in skill acquisition. The purpose of this study was to explore resident perceptions, training experiences, and preferences regarding laparoscopic simulation training. Our goal was to profile resident participation in surgical skills simulation, recognize potential barriers to voluntary simulator use, and identify simulation tools and tasks preferred by residents. Furthermore, this study may help to inform whether mandatory/protected training time, as part of the residents' curriculum is essential to enhance participation in the simulation laboratory. METHODS A cross-sectional study on general surgery residents (postgraduate years 1-5) at Yale University School of Medicine and the University of Toronto via an online questionnaire was conducted. Overall, 67 residents completed the survey. The institutional review board approved the methods of the study. RESULTS Overall, 95.5% of the participants believed that simulation training improved their laparoscopic skills. Most respondents (92.5%) perceived that skills learned during simulation training were transferrable to the operating room. Overall, 56.7% of participants agreed that proficiency in a simulation curriculum should be mandatory before operating room experience. The simulation laboratory was most commonly used during work hours; lack of free time during work hours was most commonly cited as a reason for underutilization. Factors influencing use of the simulation laboratory in order of importance were the need for skill development, an interest in minimally invasive surgery, mandatory/protected time in a simulation environment as part of the residency program curriculum, a recommendation by an attending surgeon, and proximity of the simulation center. The most preferred simulation tool was the live animal model followed by cadaveric tissue. Virtual reality simulators were among the least-preferred (25%) simulation tools. Most residents (91.0%) felt that mandatory/protected time in a simulation environment should be introduced into resident training protocols. CONCLUSIONS Mandatory and protected time in a simulation environment as part of the resident training curriculum may improve participation in simulation training. A comprehensive curriculum, which includes the use of live animals, cadaveric tissue, and virtual reality simulators, may enhance the laparoscopic training experience and interest level of surgical trainees.
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Affiliation(s)
- Shohan Shetty
- The Stanley J. Dudrick Department of Surgery, Saint Mary's Hospital, Waterbury, Connecticut.
| | - Boris Zevin
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | | | - Kurt E Roberts
- Department of Surgery, Yale University School of Medicine, New Haven, Connecticut
| | - Andrew J Duffy
- Department of Surgery, Yale University School of Medicine, New Haven, Connecticut
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Escobar MA, Hartin CW, McCullough LB. Should general surgery residents be taught laparoscopic pyloromyotomies? An ethical perspective. JOURNAL OF SURGICAL EDUCATION 2014; 71:102-109. [PMID: 24411432 DOI: 10.1016/j.jsurg.2013.06.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Revised: 06/04/2013] [Accepted: 06/30/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVES The authors examine the ethical implications of teaching general surgery residents laparoscopic pyloromyotomy. DESIGN/PARTICIPANTS Using the authors' previously presented ethical framework, and examining survey data of pediatric surgeons in the United States and Canada, a rigorous ethical argument is constructed to examine the question: should general surgery residents be taught laparoscopic pyloromyotomies? RESULTS A survey was constructed that contained 24 multiple-choice questions. The survey included questions pertaining to surgeon demographics, if pyloromyotomy was taught to general surgery and pediatric surgery residents, and management of complications encountered during pyloromyotomy. A total of 889 members of the American Pediatric Surgical Association and Canadian Association of Paediatric Surgeons were asked to participate. The response rate was 45% (401/889). The data were analyzed within the ethical model to address the question of whether general surgery residents should be taught laparoscopic pyloromyotomies. CONCLUSIONS From an ethical perspective, appealing to the ethical model of a physician as a fiduciary, the answer is no. DEFINITIONS We previously proposed an ethical model based on 2 fundamental ethical principles: the ethical concept of the physician as a fiduciary and the contractarian model of ethics. The fiduciary physician practices medicine competently with the patient’s best interests in mind. The role of a fiduciary professional imposes ethical standards on all physicians, at the core of which is the virtue of integrity, which requires the physician to practice medicine to standards of intellectual and moral excellence. The American College of Surgeons recognizes the need for current and future surgeons to understand professionalism, which is one of the 6 core competencies specified by the Accreditation Council for Graduate Medical Education. Contracts are models of negotiation and ethically permissible compromise. Negotiated assent or consent is the core concept of contractarian bioethics. Nonnegotiable goods are goals for residency training that should never be sacrificed or negotiated away. Fiduciary responsibility to the patient, regardless of level of training, should never be compromised, because doing so violates the professional virtue of integrity. The education of the resident is paramount to afford him or her the opportunity to provide competent care without supervision to future patients. Such professional competence is the intellectual and clinical foundation of fiduciary responsibility, making achievement of educational goals during residency training another nonnegotiable good.
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Affiliation(s)
- Mauricio A Escobar
- Department of Surgery, University of Washington, Seattle, Washington; Pediatric Surgical Services, Mary Bridge Children's Hospital & Health Center, Tacoma, Washington.
| | - Charles W Hartin
- Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - Laurence B McCullough
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas
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Sánchez-Peralta LF, Sánchez-Margallo FM, Pagador JB, Moyano-Cuevas JL, Aguilera EJG, Noguera-Aguilar JF. E-Learning and Multimedia Contents for Minimally Invasive Surgery Learning. INTERNATIONAL JOURNAL OF E-HEALTH AND MEDICAL COMMUNICATIONS 2013. [DOI: 10.4018/jehmc.2013040106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Background: Minimally Invasive Surgery has revolutionized the surgical practice for the last years but it presents specific training processes. At the same time, e-Learning platforms and multimedia contents are now having great success within teaching processes in different fields. Purpose: to determine perception of surgeons towards e-MIS: e-Learning and multimedia contents for minimally invasive surgery. Methods: A 19-item online survey was sent. Statistical and descriptive analyses were performed. Results: 307 surgeons responded to the survey. 99% of participants agree to include new technologies in surgical learning and 99.3% consider surgical videos as a good training tool. Conclusion: The widespread use and capabilities of e-Learning together with the use of surgical videos within the surgical learning process makes possible creating new technological systems and tools that address current problems in surgical training derived from time constraints and patient safety concerns.
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Affiliation(s)
- Luisa F. Sánchez-Peralta
- Bioengineering and Health Technologies Unit, Jesús Usón Minimally Invasive Surgery Centre, Cáceres, Spain
| | | | - José Blas Pagador
- Bioengineering and Health Technologies Unit, Jesús Usón Minimally Invasive Surgery Centre, Cáceres, Spain
| | - José Luis Moyano-Cuevas
- Bioengineering and Health Technologies Unit, Jesús Usón Minimally Invasive Surgery Centre, Cáceres, Spain
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Zevin B, Aggarwal R, Grantcharov TP. Simulation-based training and learning curves in laparoscopic Roux-en-Y gastric bypass. Br J Surg 2012; 99:887-95. [PMID: 22511220 DOI: 10.1002/bjs.8748] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2012] [Indexed: 12/28/2022]
Abstract
BACKGROUND Ex vivo simulation-based technical skills training has been shown to improve operating room performance and shorten learning curves for basic laparoscopic procedures. The application of such training for laparoscopic Roux-en-Y gastric bypass (LRYGBP) has not been reviewed. METHODS Relevant studies were identified by one author from a search of MEDLINE and Embase databases from 1 January 1994 to 30 November 2010. Studies examining the learning curves and ex vivo training methods for LRYGBP were included; all other types of bariatric operations were excluded. A manual search of the references was also performed to identify additional potentially relevant papers. RESULTS Twelve studies (5 prospective and 7 retrospective case series) were selected for review. The learning curve for LRYGBP was reported to be 50-100 procedures. Bench-top laparoscopic jejunojejunostomy, anaesthetized animals and Thiel human cadavers made up the bulk of the reported models for ex vivo training. Most studies were of relatively poor quality. An evidence-based ex vivo training curriculum for LRYGBP is currently lacking. CONCLUSION Better quality studies are needed to define the learning curve for LRYGBP. Future studies should focus on the design and validation of training models, and a comprehensive curriculum for training and assessment of cognitive, technical and non-technical components of competency for laparoscopic bariatric surgery.
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Affiliation(s)
- B Zevin
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
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The road to reduced port surgery: from single big incisions to single small incisions, and beyond. World J Surg 2011; 35:1526-31. [PMID: 21523502 DOI: 10.1007/s00268-011-1099-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Single-port surgery has seen almost as rapid an application as multiport laparoscopy during the early 1990s. Hopefully, we will learn from our predecessors to apply the dictums of safety and science as we move forward with this new technique to ensure adequate adoption and successful outcomes with limited errors and concerns along the way.
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Lirici MM. Surgeons, surgery, surgical skills. MINIM INVASIV THER 2010; 19:316-7. [PMID: 20704526 DOI: 10.3109/13645706.2010.507336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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