Tichansky D S, Taddeucci R J, Harper J, Madan A K
Section of Minimally Invasive Surgery, Department of Surgery, University of Tennessee Health Science, 956 Court Avenue, Ste. G218, Memphis, TN 38163, USA.
Surg Endosc. 2008 Mar;22(3):650-4. doi: 10.1007/s00464-007-9430-6.
With the increase in minimally invasive surgery (MIS) fellowships, the concept of the ideal and standardized training curriculum is emerging in importance. The authors hypothesize that the procedure mix in current MIS training is different from what current MIS fellows would expect for their "ideal" fellowship.
An anonymous survey of current MIS fellows examined their perceptions of the case diversity and volume they expect to perform in their fellowships as compared with an ideal fellowship. Differences between expected and ideal case volume were analyzed using Wilcoxon tests.
A total of 32 questionnaires were returned. Current MIS fellows believe their expected training will exceed the ideal volume of laparoscopic cholecystectomies (p = 0.002). They believe their expected training is equivalent to ideal training in laparoscopic gastric bypass, ventral herniorraphy, inguinal herniorraphy, antireflux procedures, appendectomy, and diagnostic endoscopy (nonsignificant difference). However, current expected training falls short of their "ideal" case volume in laparoscopic gastric banding, colectomy, common bile duct exploration, gastrectomy, esophagectomy, splenectomy, adrenalectomy, hepatectomy, nephrectomy, and pancreatectomy (p < 0.05). The current MIS fellows also expect that their thoracoscopic, therapeutic endoscopy, and robotic procedure volume will be less than "ideal" (p < 0.05).
In 13 of 20 procedure types, current MIS fellows expect to perform a smaller case volume than in an "ideal" fellowship. The ideal case volume in the MIS fellowship curriculum needs to be defined better.
随着微创外科（MIS） fellowship项目的增加，理想且标准化培训课程的概念正变得越发重要。作者推测，当前MIS培训中的手术组合与当前MIS fellowship学员对其“理想” fellowship的期望不同。
对当前MIS fellowship学员进行匿名调查，考察他们对在其fellowship期间期望进行的病例多样性和数量的看法，并与理想的fellowship进行比较。使用Wilcoxon检验分析预期病例数量与理想病例数量之间的差异。
共返回32份问卷。当前MIS fellowship学员认为他们预期的培训腹腔镜胆囊切除术数量将超过理想数量（p = 0.002）。他们认为其预期培训在腹腔镜胃旁路术、腹疝修补术、腹股沟疝修补术、抗反流手术、阑尾切除术和诊断性内镜检查方面等同于理想培训（无显著差异）。然而，当前预期培训在腹腔镜胃束带术、结肠切除术、胆总管探查术、胃切除术、食管切除术、脾切除术、肾上腺切除术、肝切除术、肾切除术和胰腺切除术方面的“理想”病例数量不足（p < 0.05）。当前MIS fellowship学员还预期他们的胸腔镜、治疗性内镜检查和机器人手术数量将少于“理想”数量（p < 0.05）。
在20种手术类型中的13种，当前MIS fellowship学员预期进行的病例数量比“理想” fellowship中的少。MIS fellowship课程中的理想病例数量需要更好地界定。
