Manuel-Palazuelos JC, Alonso-Martín J, Rodríguez-Sanjuan JC, Fernández Díaz MJ, Gutiérrez Cabezas JM, Revuelta-Alvarez S, Morales-García DJ, Herrera Noreña L, Gómez-Fleitas M. [Surgical resident training program in minimally invasive surgery experimental laboratory (CENDOS)].
Cir Esp 2009;
85:84-91. [PMID:
19231463 DOI:
10.1016/j.ciresp.2008.07.004]
[Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2008] [Accepted: 07/07/2008] [Indexed: 01/08/2023]
Abstract
INTRODUCTION
The rapid development of laparoscopic surgery makes resident training programmes necessary.
OBJECTIVE
To analyse the results of a structured programme of laparoscopic training in an experimental laboratory.
MATERIAL AND METHOD
From 2003 until 2007, we trained 11 general surgery residents for 20 h every 3 months, for three years. The practice consisted of suture and anastomosis in Endo-Trainer with animal organs, as well as laparoscopic techniques in live animals. In the Endo-Trainer practice we evaluated the time and quality of anastomosis performance. In laparoscopic techniques (cholecystectomy and anti-reflux surgery) a task table was evaluated, from 0 (no errors) to 100 (severe lesion).
RESULTS
In total, 314 anastomosis were performed by the 11 residents, with a median of 28.5 per resident (24-42). The mean time for the first gastro-jejunal anastomosis was 135 min (100-140) and 65 min (57.5-105) for the first jejunal-jejunal anastomosis. Maximum learning was achieved after 45 training hours. There were no appreciable differences between both types of anastomosis. There was inadequate anastomosis quality due to leakage in 17.1% during the learning period and 13.7% during the consolidation period. In the animal, 172 procedures were performed. In cholecystectomy and anti-reflux surgery the mean scores were 2.4 and 5.6 points, respectively. In the remaining procedures, subjectively evaluated by the monitors, the quality was adequate in 65%, deficient in 22% and highly deficient in 13%.
CONCLUSIONS
This structured programme of laparoscopic skills based on intestinal anastomosis allows for quicker resident training.
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