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波兰泌尿外科住院医师腹腔镜手术培训——波兰首次全国性调查结果

Urology resident training in laparoscopic surgery - results of the first national survey in Poland.

作者信息

Brzoszczyk Bartosz, Milecki Tomasz, Jarzemski Piotr, Antczak Andrzej, Antoniewicz Artur, Kołodziej Anna

机构信息

Department and Clinic of Urology, Jan Biziel University Hospital, Bydgoszcz, Poland.

Department and Clinic of Urology and Oncological Urology, Poznan University of Medical Sciences, Poznan, Poland.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2019 Sep;14(3):433-441. doi: 10.5114/wiitm.2019.81439. Epub 2019 Jan 22.

Abstract

INTRODUCTION

For many urological procedures the open approach is being replaced by the laparoscopic approach. Laparoscopy technique requires special training conditions. A well-designed, step-by step training program is significantly important for shortening the learning curve.

AIM

The purpose of the study was to evaluate urology residents' (UR) experience in laparoscopic procedures, training patterns and facilities available in departments of urology in Poland.

MATERIAL AND METHODS

The survey developed by the authors included 18 questions concerning laparoscopy training and was distributed among UR who participated in 2 courses in laparoscopic surgery for UR in Poland in 2017. The survey consisted of questions regarding the number of laparoscopic procedures, acquired laparoscopic experience, laparoscopic simulation training and motivation for further learning.

RESULTS

Of the 2017 invited UR in Poland, 108 (34%) completed the survey. Seventy-two (78%) UR from the study group have access to laparoscopic surgery in their department. Only 20 (25%) of urology departments are equipped with a laparoscopy box and a small number of UR perform regular training. As a primary operator basic (varicocele repair) and advanced (e.g. radical nephrectomy, radical prostatectomy, nephron-sparing surgery) laparoscopic procedures are performed respectively by 55 (71%) UR and 8 (10%) UR. Most residents evaluated their laparoscopic skills as poor (15, 19%), very poor (31, 40%) or absent (10, 13%), while only 22 (28%) evaluated them as at least satisfactory.

CONCLUSIONS

Laparoscopic technique is available in most Polish training centers. However, the majority of UR consider their skills unsatisfactory. Additionally, a large number of Polish UR do not have access to intensive training. UR considered that their availability of training courses and fellowships is low. Surgical exposure among Polish UR comprises mainly minor laparoscopic procedures.

摘要

引言

对于许多泌尿外科手术而言,开放手术方法正逐渐被腹腔镜手术方法所取代。腹腔镜技术需要特殊的培训条件。精心设计的循序渐进的培训计划对于缩短学习曲线至关重要。

目的

本研究旨在评估波兰泌尿外科住院医师在腹腔镜手术方面的经验、培训模式以及泌尿外科科室现有的设施。

材料与方法

作者制定的调查问卷包含18个关于腹腔镜培训的问题,并分发给了2017年在波兰参加过两期针对泌尿外科住院医师的腹腔镜手术课程的住院医师。该调查问卷包括有关腹腔镜手术数量、获得的腹腔镜经验、腹腔镜模拟培训以及进一步学习动机等问题。

结果

在2017年受邀的波兰泌尿外科住院医师中,108人(34%)完成了调查。研究组中有72人(78%)所在科室能够开展腹腔镜手术。只有20个(25%)泌尿外科科室配备了腹腔镜训练箱,且只有少数住院医师进行定期培训。作为主要术者,分别有55人(71%)和8人(10%)进行过基础的(精索静脉曲张修复术)和高级的(如根治性肾切除术、根治性前列腺切除术、保留肾单位手术)腹腔镜手术。大多数住院医师将自己的腹腔镜技能评为差(15人,19%)、非常差(31人,40%)或没有(10人,13%),而只有22人(28%)认为自己的技能至少令人满意。

结论

大多数波兰培训中心都具备腹腔镜技术。然而,大多数住院医师认为自己的技能不令人满意。此外,大量波兰住院医师无法获得强化培训。住院医师认为他们获得培训课程和进修机会的可能性较低。波兰住院医师的手术操作主要包括小型腹腔镜手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c1f6/6748061/8d093081cbd4/WIITM-14-34719-g001.jpg

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