Abdelshehid Corollos S, Eichel Louis, Lee David, Uribe Carlos, Boker John, Basillote Jay, McDougall Elspeth M, Clayman Ralph V, Winfield Howard N, Gill Inderbir S, Nakada Steve Y, Erturk Erdal, Babayan Richard, Shalhav Arieh L, Sosa R Ernest
Department of Urology, University of California-Irvine, Orange, California 92868, USA.
J Endourol. 2005 Jan-Feb;19(1):15-20. doi: 10.1089/end.2005.19.15.
We examined the status of laparoscopy in urology and the impact of residency and fellowship training on the performance of laparoscopy as primary surgeon. We also examined whether performing nonsurgical tasks requiring two-handed dexterity had any link to the adoption of laparoscopic techniques by urologists.
A total of 8760 laparoscopy questionnaires containing 135 queries were mailed to urologists listed on the American Urological Association practicing urologists mailing list. The questions sought information on area of practice, time in practice, fellowship training, ambidexterity, laparoscopic experience, and experience with robotics. The response rate was 1.8% (155 of 8760).
There appeared to be no significant correlation between the performance of laparoscopic surgery and participation in activities requiring bimanual dexterity. However, a correlation of strong statistical significance did exist between laparoscopic residency training and performance of laparoscopy after residency (p=0.003. There also was a correlation between fellowship training in laparoscopy/endourology and doing laparoscopy as primary surgeon.
Participation in laparoscopic surgery during residency training is a major determining factor in performance of laparoscopy as a primary surgeon in practice. Younger surgeons trained in laparoscopy during residency are performing more laparoscopy post residency than those without laparoscopic training during residency. At present, there is a need to train more urologists in laparoscopy at the postgraduate level.
我们研究了腹腔镜技术在泌尿外科中的应用现状，以及住院医师培训和专科培训对作为主刀医生进行腹腔镜手术操作的影响。我们还研究了执行需要双手灵巧操作的非手术任务是否与泌尿外科医生采用腹腔镜技术存在任何关联。
总共向美国泌尿外科协会执业泌尿外科医生邮件列表中列出的泌尿外科医生邮寄了8760份包含135个问题的腹腔镜手术调查问卷。这些问题旨在获取有关执业领域、执业时间、专科培训、双手灵巧性、腹腔镜手术经验和机器人手术经验的信息。回复率为1.8%（8760份中的155份）。
腹腔镜手术操作与参与需要双手灵巧操作的活动之间似乎没有显著相关性。然而，腹腔镜住院医师培训与住院医师培训后进行腹腔镜手术操作之间确实存在具有高度统计学意义的相关性（p = 0.003）。腹腔镜/腔内泌尿外科专科培训与作为主刀医生进行腹腔镜手术之间也存在相关性。
住院医师培训期间参与腹腔镜手术是在实际工作中作为主刀医生进行腹腔镜手术操作的一个主要决定因素。在住院医师培训期间接受腹腔镜手术培训的年轻外科医生在住院医师培训后比未接受腹腔镜培训的医生进行更多的腹腔镜手术。目前，有必要在研究生阶段培训更多的泌尿外科医生掌握腹腔镜技术。
