Ieiri Satoshi, Nakatsuji Takanori, Higashi Mayumi, Akiyoshi Junko, Uemura Munenori, Konishi Kouzou, Onimaru Manabu, Ohuchida Kenoki, Hong Jaesung, Tomikawa Morimasa, Tanoue Kazuo, Hashizume Makoto, Taguchi Tomoaki
Department of Pediatric Surgery, Reproductive and Developmental Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Pediatr Surg Int. 2010 Oct;26(10):947-54. doi: 10.1007/s00383-010-2665-7.
Pediatric surgeons require highly advanced skills when performing endoscopic surgery, but their experience with such cases tend to be limited in comparison to general surgeons. The aim of this study was to evaluate the effectiveness of basic endoscopic surgery training for less-experienced young pediatric surgeons and then compare their skills with those of general surgeons.
The surgeons (n = 477) subjected to this study underwent a 2-day endoscopic skill training program, consisting of lectures, box training, VR simulator training, tissue training, and live tissue training. The trainees were divided into two groups: P (pediatric surgeons, n = 33) and G (general surgeons, n = 444). The trainees were required to make a continuous suture along a circle measuring 2.5 cm in diameter and the findings were evaluated both before and after training. A statistical analysis was conducted using the unpaired t test.
The number of experienced cases totaled 20.8 ± 23.9 in P and 60.6 ± 80.5 in G (p < 0.001). The number of completed sutures before training was 1.4 ± 1.1 in P and 1.9 ± 1.5 in G (p < 0.05). The number of completed sutures after training was 4.1 ± 1.3 in P and 3.9 ± 1.9 in G (p > 0.05). The economy and speed of the forceps improved, however, the number of errors increased.
Less-experienced pediatric surgeons improved their surgical skill and ability until reaching almost the same level as that observed in more experienced general surgeons during training, however, the number of errors after training increased in comparison to before training. As a result, this program needs to be modified to reduce the number of errors while enabling pediatric surgeons to master the safe and precise surgical techniques needed in this field.
小儿外科医生在进行内镜手术时需要高度先进的技能,但与普通外科医生相比,他们处理此类病例的经验往往有限。本研究的目的是评估针对经验较少的年轻小儿外科医生进行基础内镜手术培训的效果,然后将他们的技能与普通外科医生的技能进行比较。
参与本研究的外科医生(n = 477)参加了为期2天的内镜技能培训项目,该项目包括讲座、箱式训练、虚拟现实模拟器训练、组织训练和活体组织训练。受训者分为两组:P组(小儿外科医生,n = 33)和G组(普通外科医生,n = 444)。要求受训者沿着直径为2.5厘米的圆圈进行连续缝合,并在训练前后对结果进行评估。使用不成对t检验进行统计分析。
P组的经验病例总数为20.8±23.9,G组为60.6±80.5(p < 0.001)。训练前完成的缝合数,P组为1.4±1.1,G组为1.9±1.5(p < 0.05)。训练后完成的缝合数,P组为4.1±1.3,G组为3.9±1.9(p > 0.05)。镊子的经济性和速度有所提高,然而,错误数量增加了。
经验较少的小儿外科医生在训练期间提高了他们的手术技能和能力,直至达到与经验更丰富的普通外科医生几乎相同的水平,然而,与训练前相比,训练后错误数量增加了。因此,需要修改该项目,以减少错误数量,同时使小儿外科医生掌握该领域所需的安全、精确的手术技术。