Light D, Bawa S, Gallagher P, Horgan L
Northumbria NHS Trust, North Shields, UK.
Ann R Coll Surg Engl. 2017 Nov;99(8):614-616. doi: 10.1308/rcsann.2017.0094. Epub 2017 Jul 6.
Introduction The Ethicon™ laparoscopic inguinal groin hernia training (LIGHT) course is an educational course based on three days of teaching on laparoscopic hernia surgery. The first day involves didactic lectures with tutorials. The second day involves practical cadaveric procedures in laparoscopic hernia surgery. The third day involves direct supervision by a consultant surgeon during laparoscopic hernia surgery on a real patient. We reviewed our outcomes for procedures performed on real patients on the final day of the course for early complications and outcomes. Methods A retrospective study was undertaken of patients who had laparoscopic hernia surgery as part of the LIGHT course from 2013 to 2015. A matched control cohort of patients who had elective laparoscopic hernia surgery over the study period was identified. These patients had their surgery performed by the same consultant general surgeons involved in delivering the course. All patients were followed up at 6 weeks postoperatively. Results A total of 60 patients had a laparoscopic inguinal hernia repair and 23 patients had a laparoscopic ventral hernia repair during the course. The mean operative time for laparoscopic inguinal hernia repair was 48 minutes for trainees (range 22-90 minutes) and 35 minutes for consultant surgeons (range 18-80 minutes). There were no intraoperative injuries or returns to theatre in either group. All the patients operated on during the course were successfully performed as daycase procedures. The mean operative time for laparoscopic ventral hernia repair was 64 minutes for trainees (range 40-120 minutes) and 51 minutes for consultant surgeons (range 30-130 minutes). Conclusions The outcomes of patients operated on during the LIGHT course are comparable to procedures performed by a consultant. Supervised operating by trainees is a safe and effective educational model in hernia surgery.
引言 爱惜康™腹腔镜腹股沟疝修补术培训（LIGHT）课程是一门基于为期三天的腹腔镜疝修补手术教学的教育课程。第一天包括理论讲座和辅导。第二天包括腹腔镜疝修补手术的尸体实践操作。第三天包括在为真实患者进行腹腔镜疝修补手术时由顾问外科医生进行直接监督。我们回顾了在课程最后一天对真实患者进行手术的早期并发症和结果。
方法 对2013年至2015年期间作为LIGHT课程一部分接受腹腔镜疝修补手术的患者进行了一项回顾性研究。确定了在研究期间接受择期腹腔镜疝修补手术的匹配对照队列患者。这些患者由参与授课的同一位普通外科顾问医生进行手术。所有患者在术后6周进行随访。
结果 在课程期间，共有60例患者接受了腹腔镜腹股沟疝修补术，23例患者接受了腹腔镜腹疝修补术。腹腔镜腹股沟疝修补术学员的平均手术时间为48分钟（范围22 - 90分钟），顾问外科医生为35分钟（范围18 - 80分钟）。两组均无术中损伤或返回手术室的情况。课程期间所有接受手术的患者均成功作为日间手术完成。腹腔镜腹疝修补术学员的平均手术时间为64分钟（范围40 - 120分钟），顾问外科医生为51分钟（范围30 - 130分钟）。
结论 在LIGHT课程中接受手术的患者的结果与顾问医生进行的手术相当。学员在监督下进行手术是疝修补手术中一种安全有效的教育模式。
