Giger Urs, Frésard Isabelle, Häfliger André, Bergmann Mathias, Krähenbühl Lukas
Department of Surgery, Hôpital Cantonal Fribourg, Fribourg, Switzerland.
Surg Endosc. 2008 Apr;22(4):901-6. doi: 10.1007/s00464-007-9502-7. Epub 2007 Aug 18.
Nowadays, the laparoscopic approach represents the gold standard for a wide range of various basic and advanced procedures. To reduce the learning curve in advanced laparoscopic surgery, the search for new teaching tools is of utmost importance. Our experiences with a new teaching tool to train advanced laparoscopic procedures are reported.
Hands-on training courses in colon, hernia, bariatric and vascular surgery using Thiel human cadavers (THCs) were organised by the Swiss Association of Laparoscopic and Thoracoscopic Surgery (SALTS). The courses were held by consultant surgeons expert in the field of minimal invasive surgery (MIS). At the end of each course, data was collected using a standardised, anonymous questionnaire using a Likert scale (1 = strongly disagree; 2 = disagree; 3 = neither agree nor disagree; 4 = agree; 5 = strongly agree). Data are presented as mean +/- standard deviation (SD), percentages (%) or total number (n), if indicated.
From January 2005 to May 2006, six courses (colon = 2; hernia = 2; bariatric = 1; vascular = 1) were organized with a total of 33 participants (31 consultant surgeons; two senior residents). The authenticity of tissue colour, tissue consistency and operative tactility, respectively, were stated for the courses as follows: colon (mean: 4.4/4.2/4.2), hernia (mean: 4.3/4.2/4.0), bariatric (mean: 4.5/4.8/4.3) and vascular (mean: 2.8/2.8/2.6) courses. A high mean overall satisfaction with the courses (colon: 4.0; hernia: 4.2; bariatric: 5.0 and vascular surgery: 4.1) was also observed. All participants of the colon, bariatric, hernia and vascular courses will recommend the courses to other surgeons.
Training on THCs might be an excellent additional model to teach advanced bariatric, hernia and colon surgery. However, an important issue that remains to be defined is which training model (THC, anesthetized animals, virtual computer training, etc.) is the most appropriate for the curriculum of the skill or procedure that is being trained.
如今,腹腔镜手术方法是广泛的各种基础和高级手术的金标准。为了缩短高级腹腔镜手术的学习曲线,寻找新的教学工具至关重要。本文报告了我们使用一种新的教学工具培训高级腹腔镜手术的经验。
瑞士腹腔镜与胸腔镜外科学会(SALTS)组织了使用蒂尔人体尸体(THC)进行结肠、疝气、减肥和血管手术的实践培训课程。这些课程由微创外科(MIS)领域的顾问外科医生专家授课。在每门课程结束时,使用标准化的匿名李克特量表问卷(1 = 强烈不同意;2 = 不同意;3 = 既不同意也不反对;4 = 同意;5 = 强烈同意)收集数据。如有指示,数据以平均值±标准差(SD)、百分比(%)或总数(n)表示。
2005年1月至2006年5月,共组织了六门课程(结肠 = 2;疝气 = 2;减肥 = 1;血管 = 1),共有33名参与者(31名顾问外科医生;两名高级住院医生)。各课程对组织颜色、组织质地和手术触感的真实性评价如下:结肠课程(平均值:4.4/4.2/4.2)、疝气课程(平均值:4.3/4.2/4.0)、减肥课程(平均值:4.5/4.8/4.3)和血管课程(平均值:2.8/2.8/2.6)。还观察到对这些课程的总体平均满意度较高(结肠:4.0;疝气:4.2;减肥:5.0;血管手术:4.1)。结肠、减肥、疝气和血管课程的所有参与者都将向其他外科医生推荐这些课程。
使用THC进行培训可能是教授高级减肥、疝气和结肠手术的优秀补充模式。然而,一个有待确定的重要问题是哪种培训模式(THC、麻醉动物、虚拟计算机培训等)最适合所培训技能或手术的课程设置。