Division of Urology, University of Sao Paulo Medical School, SP, Brazil.
Int Braz J Urol. 2011 Jan-Feb;37(1):108-11; discussion 112. doi: 10.1590/s1677-55382011000100014.
Laparoscopy has certainly brought considerable benefits to patients, but laparoscopic surgery requires a set of skills different from open surgery, and learning in the operating room may increase surgical time, and even may be harmful to patients. Several training programs have been developed to decrease these potential prejudices.
to describe the laparoscopic training program for urological residents of the "Hospital das Clinicas" of the Sao Paulo Medical School, to report urological procedures that are feasible in dry and wet labs, and to perform a critical analysis of the cost-benefit relation of advanced laparoscopic skills laboratory.
The laparoscopic skill lab has two virtual simulators, three manual simulators, and four laparoscopic sets for study with a porcine model. The urology residents during their first year attend classes in the virtual and manual simulator and helps the senior urological resident in activities carried out with the laparoscopic sets. During the second year, the urological resident has six periods per week, each period lasting four hours, to perform laparoscopic procedures with a porcine model.
In a training program of ten weeks, one urological resident performs an average of 120 urological procedures. The most common procedures are total nephrectomy (30%), bladder suture (30%), partial nephrectomy (10%), pyeloplasty (10%), ureteral replacement or transuretero anastomosis (10%), and others like adrenalectomy, prostatectomy, and retroperitoneoscopy. These procedures are much quicker and caused less morbidity.
Laparoscopic skills laboratory is a good method for achieving technical ability.
腹腔镜技术确实给患者带来了很多益处，但腹腔镜手术需要一套不同于开放手术的技能，在手术室中学习可能会延长手术时间，甚至可能对患者造成伤害。为此，已经开发了几种培训计划来减少这些潜在的偏见。
描述圣保罗医学院“临床医院”泌尿科住院医师的腹腔镜培训计划，报告在干实验室和湿实验室中可行的泌尿科手术，并对高级腹腔镜技能实验室的成本效益关系进行批判性分析。
腹腔镜技能实验室有两个虚拟模拟器、三个手动模拟器和四个腹腔镜套件，用于在猪模型上进行研究。泌尿科住院医师在第一年参加虚拟和手动模拟器的课程，并协助资深泌尿科住院医师进行腹腔镜套件的活动。在第二年，泌尿科住院医师每周有六节课，每节课持续四个小时，在猪模型上进行腹腔镜手术。
在为期十周的培训计划中，一名泌尿科住院医师平均完成 120 项泌尿科手术。最常见的手术是全肾切除术（30%）、膀胱缝合术（30%）、部分肾切除术（10%）、肾盂成形术（10%）、输尿管替代或经输尿管吻合术（10%）以及肾上腺切除术、前列腺切除术和后腹腔镜检查术等其他手术。这些手术更快，发病率更低。
腹腔镜技能实验室是获得技术能力的好方法。
