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Significant transfer of surgical skills obtained with an advanced laparoscopic training program to a laparoscopic jejunojejunostomy in a live porcine model: feasibility of learning advanced laparoscopy in a general surgery residency

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Abstract

Background

Simulation may provide a solution to acquire advanced laparoscopic skills, thereby completing the curriculum of residency programs in general surgery. This study was designed to present an advanced simulation-training program and to assess the transfer of skills to a live porcine model.

Methods

First-year residents were assessed in a 14-session advanced laparoscopic training program followed by performing a jejunojejunostomy in a live porcine model. Previous and after training assessments at the bench model were compared to a single performance of six expert laparoscopic surgeons. Results obtained by trainees at the porcine model assessment were compared to those of 11 general surgeons without any laparoscopic lab-simulation training and 6 expert laparoscopic surgeons. In all assessments, global and specific OSATS scores, operative time, and covered path length of hands were registered.

Results

Twenty-five residents improved significantly their global and specific OSATS score median at the bench model [7 (range, 6–11) vs. 23 (range, 21–24); p < 0.05 and 7 (range, 4–8) vs. 18 (range, 18–19); p < 0.05, respectively] and obtained significantly better scores on the porcine model compared with general surgeons with no lab-simulation training [21 (range, 20.5–21) vs. 8 (range, 12–14); p < 0.05]. The results were comparable to those achieved by expert certificated bariatric surgeons. Total path lengths registered for trainees were more efficient post-training and significantly lower compared with general surgeons on the porcine model [7 (range, 6–11) vs. 23 (range, 21–24); p < 0.05] with no statistical difference compared with experts.

Conclusions

Trainees significantly improved their advanced laparoscopic skills to a level compared with expert surgeons. More importantly, these acquired skills were transferred to a more complex live model.

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Acknowledgments

The Department of Digestive Surgery financed this work and it was partially supported by grants of the National Commission for Scientific and Technological Research (CONICYT), FONDECYT No. 1100436 to A.R. The authors thank Oslando Padilla for his support with the statistical analysis of the data.

Disclosure

The authors report no conflict of interest. The authors are responsible for the content and writing of the article.

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Authors and Affiliations

  1. Experimental Surgery Simulation Center, Department of Digestive Surgery, Hospital Clínico, Faculty of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 391, Santiago, Chile

    Julián Varas, Ricardo Mejía, Felipe Maluenda, Erwin Buckel, José Salinas, Jorge Martínez, Nicolás Jarufe & Camilo Boza

  2. Department of Gastroenterology and Centre for Medical Education, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile

    Arnoldo Riquelme

  3. Department of Biosurgery and Surgical Technology, Imperial College, London, SW7 2AZ, UK

    Rajesh Aggarwal

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  1. Julián Varas
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Correspondence to Camilo Boza.

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Varas, J., Mejía, R., Riquelme, A. et al. Significant transfer of surgical skills obtained with an advanced laparoscopic training program to a laparoscopic jejunojejunostomy in a live porcine model: feasibility of learning advanced laparoscopy in a general surgery residency. Surg Endosc 26, 3486–3494 (2012). https://doi.org/10.1007/s00464-012-2391-4

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  • DOI: https://doi.org/10.1007/s00464-012-2391-4

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