Department of Surgery, Deventer Hospital, Deventer, The Netherlands.
Int J Colorectal Dis. 2011 Jul;26(7):941-7. doi: 10.1007/s00384-011-1161-4. Epub 2011 Mar 10.
A steep learning curve exists for surgeons to become skilled in laparoscopic colon resection. Our institute offers a proctored training programme. The purpose of this descriptive study was to evaluate whether the course resulted in adoption of laparoscopic colorectal surgery into clinical practice, explore post-course practice patterns and analyse the outcome of surgical performance.
Between 2003 and 2008, 26 surgeons were trained by our institute. The course consisted of 24 elective laparoscopic resections under direct supervision. A questionnaire and a prospective post-course web-based registration were used to analyse the effect of the training and the outcome of surgical performance.
The response rate of the questionnaire was 85%. The majority had not performed any laparoscopic colon resections before attending the course. All 24 respondents successfully implemented laparoscopy into daily practice. After the course, 70% of all sigmoid resections were performed laparoscopically in contrast with 0% of all transverse colon resections. The results of the trainees after following the course are equal to results of other studies.
A proctored training programme, consisting of 24 supervised cases, is safe and feasible. For adequate monitoring, participating in a post-course registry should be obligatory.
外科医生需要经历陡峭的学习曲线才能熟练掌握腹腔镜结肠切除术。我们的机构提供有监管的培训计划。本研究旨在评估该课程是否使腹腔镜结直肠手术在临床实践中得到应用,探索课程后的实践模式,并分析手术绩效的结果。
在 2003 年至 2008 年期间,有 26 名外科医生在我们机构接受了培训。课程包括 24 例在直接监督下进行的选择性腹腔镜切除术。通过问卷调查和课程后基于网络的前瞻性注册,分析培训效果和手术绩效的结果。
问卷的回复率为 85%。大多数外科医生在参加课程前从未进行过任何腹腔镜结肠切除术。所有 24 名受访者都成功地将腹腔镜技术应用于日常实践。课程结束后,70%的乙状结肠切除术采用腹腔镜进行,而横结肠切除术无一例采用腹腔镜。培训后学员的结果与其他研究的结果相当。
由 24 例监督病例组成的监管培训计划是安全可行的。为了进行充分的监测,参加课程后注册应是强制性的。