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Assessment of resident training in laparoscopic surgery based on a digestive system anastomosis model in the laboratory

Abstract: Background: The complexity of laparoscopic surgery makes specific training out of the operating rooms necessary to shorten learning curves and to minimise morbidity rates. Our aim was to analyse the increase in laparoscopic skills after completion of a laboratory training program. Material and methods: Prospective study of surgical resident training based on anastomosis performance on an ?endotrainer.? The program consisted of 4 weeks per year (20 h per week) between 2004 and 2007. The outcome measures were the time and number of anastomosis necessary to perform a proper anastomosis. Upon completion, the anastomosis was checked by both trainee and evaluator and quality was assessed. Time and technical failures (loose suture, edge eversion, leakage) were recorded. Results: Twelve surgical residents were trained. They performed 189 jejuno-jejunal anastomoses (JJA), mean 15.8 per resident and 197 gastro-jejunal anastomoses (GJA), mean 16.4 per resident. The performance mean time was 72.7 min for JJA and 87.2 for GJA. There was a marked reduction in time from the beginning to completion of training. The percentage of flawed anastomosis decreased with training: 26.6%, 21.8%, 17.1%, 17%, 16.1%, and 10.5% after 20, 40, 60, 80, 100, and 120h, respectively. Bearing in mind reduction in both performance time and flawed anastomosis rate, it appears that after 70h of training the learning curve reaches a plateau zone. Conclusions: Intestinal anastomosis (either JJA or GJA) performed in ?endotrainer? is a suitable model for laparoscopic training, without the need of live animals. After a training period of 70 hours, the improvement seems of little benefit.

Otras publicaciones de la misma revista o congreso con autores/as de la Universidad de Cantabria

 Autoría: Juan Carlos Rodríguez Sanjuán; José Carlos Manuel Palazuelos; María José Fernández-Díez; José Manuel Gutiérrez-Cabezas; Joaquín Alonso Martín; Carlos Redondo Figuero; Luis Antonio Herrera-Noreña; Manuel Gómez Fleitas

 Fuente: Cirugía española, 2010, 87(1), 20-25

Editorial: Elsevier Doyma

 Año de publicación: 2010

Nº de páginas: 6

Tipo de publicación: Artículo de Revista

 DOI: 10.1016/j.ciresp.2009.08.003

ISSN: 0009-739X,1578-147X

Autoría

MANUEL-PALAZUELOS, CARLOS

FERNÁNDEZ-DÍEZ, MARÍA JOSÉ

GUTIÉRREZ-CABEZA, JOSÉ MANUEL

ALONSO-MARTÍN, JOAQUÍN

CARLOS GODOFREDO REDONDO FIGUERO

HERRERA-NOREÑA, LUIS ANTONIO

MANUEL GOMEZ FLEITAS