Skills acquisition for Laparoscopic gastric bypass in the training laboratory - an innovative approach

被引:45
|
作者
Aggarwal, Rajesh
Loza, Camilo
Hance, Julian
Leong, Julian
Lacy, Antonio
Darzi, Ara
机构
[1] St Marys Hosp, Imperial Coll London, Dept Biosurg & Surg Technol, London W2 1NY, England
[2] Pontificia Univ Catolica Chile, Hosp Clin, Dept Digest Surg, Santiago, Chile
[3] Univ Barcelona, Hosp Clin, Inst Digest Dis, Gastrointestinal Surg Unit, E-08007 Barcelona, Spain
关键词
technical skills; training; curriculum; proficiency-based laparoscopy; gastric bypass;
D O I
10.1007/s11695-007-9001-x
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: Laparoscopic Roux-en-Y gastric bypass (LRYGBP) is a technically demanding procedure, with a long learning curve. The aim of this study was threefold: to develop a task-based approach to training in LRYGBP, define a tool for objective technical skills assessments, and objectively determine the efficacy of this approach. Methods: Videos of expert and novice surgeons performing LRYGBP on patients and anesthetised porcine models were analyzed to define an appropriate task for skills assessment. Subsequently, a jejunojejunostomy model was developed using cadaveric porcine small bowel, placed into a video-box trainer. 27 surgeons of varying experience levels in advanced laparoscopic procedures performed the task. Assessments of technical skill were by hand motion analysis and video-based scoring. A further 16 surgeons inexperienced in LRYGBP attended a task-based hands-on training course and performed the jejuno-jejunostomy task at start and end of the course. Results: The jejuno-jejunostomy model differentiated between surgeons of varying experience levels for time taken (P<0.001), economy of movement (P=0.001) and video scores (P<0.001). Surgeons attending the training course made significant improvements in time taken (P=0.002) and economy of movement (P=0.006), although not for generic video scores (P=0.243) by the end of course. Conclusions: The structured, task-based approach for commencement of training in LRYGBP leads to objective improvements in the technical skills of inexperienced surgeons at the end of a short course. The next stage of the curriculum should be to achieve proficiency in the complete procedure on an anesthetised porcine model, prior to preceptorship on human cases.
引用
收藏
页码:19 / 27
页数:9
相关论文
共 50 条
  • [31] The Effect of Mixed-Task Basic Training in the Acquisition of Advanced Laparoscopic Skills
    Loukas, Constantinos
    Lahanas, Vasileios
    Kanakis, Meletios
    Georgiou, Evangelos
    SURGICAL INNOVATION, 2015, 22 (04) : 418 - 425
  • [32] Emotional, evaluation and skill acquisition for proficiency-based laparoscopic skills training
    Rulli, Francesco
    SURGERY, 2007, 141 (05) : 692 - 692
  • [33] RESTRICTIVE BARIATRIC TECHNIQUES CONVERTED TO GASTRIC BYPASS BY LAPAROSCOPIC APPROACH
    Serradilla, M.
    Ballesta, C.
    Gonzalez, C.
    OBESITY SURGERY, 2014, 24 (08) : 1323 - 1324
  • [34] Comparison of video trainer and virtual reality training systems on acquisition of laparoscopic skills
    Hamilton, EC
    Scott, DJ
    Fleming, JB
    Rege, RV
    Laycock, R
    Bergen, PC
    Tesfay, ST
    Jones, DB
    SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2002, 16 (03): : 406 - 411
  • [35] PORTABLE SIMULATORS TRAINING ENHANCES THE LAPAROSCOPIC SKILLS ACQUISITION: RANDOMISED CONTROLLED TRIAL
    Johnston, Thomas
    Tang, Benjie
    Nabi, Ghulam
    JOURNAL OF ENDOUROLOGY, 2011, 25 : A28 - A28
  • [36] Effect of spaced training with a box trainer on the acquisition and retention of basic laparoscopic skills
    Akdemir, Ali
    Zeybek, Burak q
    Ergenoglu, Ahmet M.
    Yeniel, Ahmet O.
    Sendag, Fatih
    INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS, 2014, 127 (03) : 309 - 313
  • [37] Training opportunities and the role of virtual reality simulation in acquisition of basic laparoscopic skills
    Aggarwal, Rajesh
    Balasundaram, Indran
    Darzi, Ara
    JOURNAL OF SURGICAL RESEARCH, 2008, 145 (01) : 80 - 86
  • [38] Advanced laparoscopic skills decrease the learning curve for laparoscopic Roux-en-Y gastric bypass
    Jason A. Breaux
    Colleen I. Kennedy
    William S. Richardson
    Surgical Endoscopy, 2007, 21 : 985 - 988
  • [39] Advanced laparoscopic skills decrease the learning curve for laparoscopic Roux-en-Y gastric bypass
    Breaux, Jason A.
    Kennedy, Colleen I.
    Richardson, William S.
    SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2007, 21 (06): : 985 - 988
  • [40] An innovative approach for laparoscopic liver resections. Training protocol
    Popa, Calin
    Voicescu, George Teo
    Pestean, Cosmin
    Graur, Florin
    Al Momani, Tareg
    Al-Hajjar, Nadim
    Liviu, Ioan
    ANNALI ITALIANI DI CHIRURGIA, 2020, 91 (01) : 105 - 111