Leake P A, Qureshi A, Plummer J, Okrainec A
Department of Surgery, Radiology, Anaesthesia and Intensive Care, The University of the West Indies, Kingston, Jamaica.
West Indian Med J. 2012 Oct;61(7):708-15.
There has been debate on the feasibility of incorporating minimally invasive surgery (MIS) into surgical practice in developing countries due to resource and training limitations. Our study establishes the current and desired state of MIS training in surgical residency programmes in the Caribbean.
An adapted version of a previously administered questionnaire was issued to surgeons and residents involved in the general surgical residency programme of The University of the West Indies in Barbados, Jamaica and Trinidad and Tobago. Data were analysed using the Statistical Package for the Social Sciences, version 17.0.
The questionnaire was sent to 41 surgeons and 41 residents with a 65% response rate. Most residents had performed less than 25 basic laparoscopic procedures. Up to 82% of residents felt that they would be unable to perform advanced laparoscopic procedures due to lack of training. The principal negative factors influencing MIS training included lack of operating room time, lack of equipment and lack of preceptor expertise. Both surgeons (83.4%) and residents (93.4%) strongly felt that a surgical skills laboratory would be helpful for the acquisition of MIS skills. Both surgeons (85.7%) and residents (100%) felt that there was a role for an MIS surgeon in fulfilling training obligations.
The basic and advanced MIS experience of residents in the Caribbean is limited. Surgeon training and resource limitations are major contributing factors. There is a strong desire on the part of surgeons and residents alike for the incorporation of more effective MIS training into the residency programme in the Caribbean.
由于资源和培训方面的限制,在发展中国家将微创手术(MIS)纳入外科实践的可行性一直存在争议。我们的研究确定了加勒比地区外科住院医师培训项目中MIS培训的现状和期望状态。
向参与巴巴多斯、牙买加和特立尼达和多巴哥西印度群岛大学普通外科住院医师培训项目的外科医生和住院医师发放了一份先前使用过的问卷的改编版。使用社会科学统计软件包第17.0版对数据进行分析。
问卷发送给了41名外科医生和41名住院医师,回复率为65%。大多数住院医师进行的基本腹腔镜手术少于25例。高达82%的住院医师认为由于缺乏培训,他们无法进行高级腹腔镜手术。影响MIS培训的主要负面因素包括手术室时间不足、设备缺乏和带教老师专业知识不足。外科医生(83.4%)和住院医师(93.4%)都强烈认为手术技能实验室有助于获得MIS技能。外科医生(85.7%)和住院医师(100%)都认为MIS外科医生在履行培训义务方面可以发挥作用。
加勒比地区住院医师的基本和高级MIS经验有限。外科医生培训和资源限制是主要促成因素。外科医生和住院医师都强烈希望在加勒比地区的住院医师培训项目中纳入更有效的MIS培训。