Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019;32(2):e1436.
doi: 10.1590/0102-672020190001e1436. Epub 2019 Apr 29.

IMPACT OF A SIMULATED LAPAROSCOPIC TRAINING PROGRAM IN A THREE-YEAR GENERAL SURGERY RESIDENCY

[Article in English, Portuguese]
Rodrigo Tejos  1 , Rubén Avila  1 , Martin Inzunza  1 , Pablo Achurra  2 , Richard Castillo  2 , Anne Rosberg  3 , Octavio Cordero  2 , Rodrigo Kusanovich  2 , Felipe Bellolio  2 , Julián Varas  1 , Jorge Martínez  2
Affiliations

IMPACT OF A SIMULATED LAPAROSCOPIC TRAINING PROGRAM IN A THREE-YEAR GENERAL SURGERY RESIDENCY

[Article in English, Portuguese]
Rodrigo Tejos et al. Arq Bras Cir Dig. 2019.

Abstract
in English, Portuguese

Background: A General Surgery Residency may last between 2-6 years, depending on the country. A shorter General Surgery Residency must optimize residents' surgical exposure. Simulated surgical training is known to shorten the learning curves, but information related to how it affects a General Surgery Residency regarding clinical exposure is scarce.

Aim: To analyze the effect of introducing a validated laparoscopic simulated training program in abdominal procedures performed by residents in a three-year General Surgery Residency program.

Methods: A non-concurrent cohort study was designed. Four-generations (2012-2015) of graduated surgeons were included. Only abdominal procedures in which the graduated surgeons were the primary surgeon were described and analyzed. The control group was of graduated surgeons from 2012 without the laparoscopic simulated training program. Surgical procedures per program year, surgical technique, emergency/elective intervention and hospital-site (main/community hospitals) were described.

Results: Interventions of 28 graduated surgeons were analyzed (control group=5; laparoscopic simulated training program=23). Graduated surgeons performed a mean of 372 abdominal procedures, with a higher mean number of medium-to-complex procedures in laparoscopic simulated training program group (48 vs. 30, p=0.02). Graduated surgeons trained with laparoscopic simulated training program performed a higher number of total abdominal procedures (384 vs. 319, p=0.04) and laparoscopic procedures (183 vs. 148, p<0.05).

Conclusions: The introduction of laparoscopic simulated training program may increase the number and complexity of total and laparoscopic procedures in a three-year General Surgery Residency.

Racional:: Residência em Cirurgia Geral pode durar entre 2-6 anos, dependendo do país. Residência mais curta deve otimizar a exposição dos residentes às cirurgias. Sabe-se que o treinamento cirúrgico simulado encurta as curvas de aprendizado, mas a informação relacionada à como isso afeta a residência em relação à exposição clínica é escassa.

Objetivo:: Analisar o efeito da introdução de um programa de treinamento laparoscópico simulado validado em procedimentos abdominais realizados por residentes em um programa de Residência em Cirurgia Geral de três anos.

Métodos:: Um estudo de coorte não simultâneo foi desenhado. Quatro gerações (2012-2015) de cirurgiões graduados foram incluídos. Apenas os procedimentos abdominais em que os cirurgiões graduados foram o cirurgião principal foram descritos e analisados. O grupo controle foi de cirurgiões graduados de 2012 sem programa de treinamento laparoscópico simulado. Procedimentos cirúrgicos por ano de programa, técnica cirúrgica, intervenção de emergência ou eletiva e local do hospital (hospitais principais/comunitários) foram descritos.

Resultados:: Intervenções de 28 cirurgiões graduados foram analisadas (controle=5; programa de treinamento simulado=23). Os cirurgiões graduados realizaram média de 372 procedimentos abdominais, com maior número médio de procedimentos de médio a complexo no grupo de programa de treinamento simulado (48 vs. 30, p=0,02). Cirurgiões graduados treinados com programa de treinamento simulado realizaram número maior de procedimentos abdominais totais (384 vs. 319, p=0,04) e procedimentos laparoscópicos (183 vs. 148, p<0,05).

Conclusões:: A introdução do programa de treinamento laparoscópico simulado pode aumentar o número e a complexidade dos procedimentos totais e laparoscópicos na Residência em Cirurgia Geral de três anos.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: none

Figures

FIGURE 1
FIGURE 1. A) Basic Laparoscopic Simulation Program (LSTP); B) advanced LSTP
FIGURE 2
FIGURE 2. A) Mean and standard deviation of all abdominal procedures; B) intermediate-complex procedures during a 3-year surgery
FIGURE 3
FIGURE 3. A) Mean and standard deviation of laparoscopic and open surgical technique during a 3-year surgery residence; B) distribution of laparoscopic procedures per year of residence
FIGURE 4
FIGURE 4. A) Number of abdominal procedures performed per year; B) number of attending surgeons per year; C) number of residents per year
FIGURE 5
FIGURE 5. A) Annual-surgical-exposure index (ASE) calculated as number of abdominal procedures divided into number of residents per year; B) annual resident-per-attending-surgeon index (RPS) calculated as number of attending surgeons divided into number of residents per year
See this image and copyright information in PMC

References

    1. Aggarwal R, Boza C, Hance J, Leong J, Lacy A, Darzi A. Skills acquisition for laparoscopic gastric bypass in the training laboratory an innovative approach. Obesity surgery. 2007;17(1):19–27. - PubMed
    1. Aggarwal R, Darzi A. Simulation to enhance patient safety why aren't we there yet? Chest. 2011;140(4):854–858. - PubMed
    1. Aggarwal R, Darzi A. Technical-skills training in the 21st century. The New England journal of medicine. 2006;355(25):2695–2696. - PubMed
    1. Al-Kadi AS, Donnon T, Oddone Paolucci E, Mitchell P, Debru E, Church N. The effect of simulation in improving students' performance in laparoscopic surgery a meta-analysis. Surgical endoscopy. 2012;26(11):3215–3224. - PubMed
    1. Asano TK, Soto C, Poulin EC, Mamazza J, Boushey RP. Assessing the impact of a 2-day laparoscopic intestinal workshop. Canadian journal of surgery Journal canadien de chirurgie. 2011;54(4):223–226. - PMC - PubMed