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单孔腹腔镜手术基本技能专项培训课程。

A specialized course of basic skills training for single-port laparoscopic surgery.

机构信息

Department of Urology, Changhai Hospital, The Second Military Medical University, Shanghai 200433, China.

出版信息

Surgery. 2011 Jun;149(6):766-75. doi: 10.1016/j.surg.2010.11.001. Epub 2011 Mar 31.

Abstract

BACKGROUND

Single-port laparoscopy (SPL) requires specialized skills; however, there are currently no specialized training courses for SPL. The aim of this study is to present an effective specialized training course of basic skills for SPL.

METHODS

We designed a specialized training course for single-port laparoscopic basic skills. The study included 10 male urology residents. The trainees practiced the traditional training course for laparoscopy basic skills for 5 days. Basic skills were assessed on day 6 and a self-efficacy confidence index was measured. On day 7, all trainees performed a traditional laparoscopic nephrectomy and single-port laparoscopic nephrectomy. The participants were then randomized into 2 groups: 5 trainees performed the specialized training course and the other 5 trainees continued to practice the traditional training course. Both groups were trained for 5 days. After completion, the trainees were tested on completing a porcine single-port laparoscopic nephrectomy. Operative performance was measured by 2 experts who were blinded to which training the student had received, using an altered global rating. In addition, participants completed a general self-efficacy instrument after performing surgeries.

RESULTS

The overall operative performance score for single-port laparoscopic surgery was significantly better in the specialized training group. A significant difference in confidence index was seen between the traditional laparoscopy training and specialized single-port training groups (18.40 ± 2.70 vs 29.4 ± 3.51, respectively; P = .001.). Four relative instrument locations which avoided the problem of crowding were also noted in the specialized training group.

CONCLUSION

The specialized training course is effective for developing SPL skills.

摘要

背景

单孔腹腔镜(SPL)需要专业技能;然而,目前没有专门针对 SPL 的培训课程。本研究旨在介绍一种有效的 SPL 基本技能专项培训课程。

方法

我们设计了一种单孔腹腔镜基本技能专项培训课程。研究纳入 10 名男性泌尿外科住院医师。学员先进行 5 天的传统腹腔镜基本技能培训课程,第 6 天评估基本技能并测量自我效能信心指数。第 7 天,所有学员均进行传统腹腔镜肾切除术和单孔腹腔镜肾切除术。然后将学员随机分为 2 组:5 名学员参加专项培训课程,另外 5 名学员继续进行传统培训课程。两组均培训 5 天。培训结束后,学员进行猪单孔腹腔镜肾切除术。由 2 名对学员接受的培训情况不知情的专家使用改良的整体评分法评估手术操作表现。此外,学员在手术后完成一般自我效能感量表。

结果

专项培训组的单孔腹腔镜手术总体操作表现评分显著更好。传统腹腔镜培训和专项单孔培训组的信心指数有显著差异(分别为 18.40 ± 2.70 和 29.4 ± 3.51,P =.001)。专项培训组还注意到了 4 个避免拥挤问题的相对器械位置。

结论

专项培训课程对于开发 SPL 技能是有效的。

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