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支持将腹腔镜缝合技能尽早纳入外科培训课程的证据。

Evidence to support the early introduction of laparoscopic suturing skills into the surgical training curriculum.

机构信息

Surgical Skills Centre, Dundee Institute for Healthcare Simulation, Ninewells Hospital and Medical School, University of Dundee, Dundee, DD1 9SY, UK.

Department of Surgery, the Second Teaching Hospital of Qingdao University, Qingdao Central Medical Group, Qingdao, China.

出版信息

BMC Med Educ. 2020 Mar 6;20(1):70. doi: 10.1186/s12909-020-1986-z.

Abstract

BACKGROUND

The objectives of this study were to investigate the relationship between the acquisition of laparoscopic suturing skills and other operative laparoscopic skills and to provide evidence to determine ideal time and duration to introduce laparoscopic suturing training.

METHODS

The first part of the study explored the relationship between the acquisition of laparoscopic suturing skills and proficiency of other operative laparoscopic skills. The second part of the study consisted of an opinion survey from senior and junior trainees on aspects of training in laparoscopic suturing.

RESULTS

One hundred twenty-eight surgical trainees participated in this study. The total scores of task performance of 57 senior surgical trainees in laparoscopic suturing skills consisting of needle manipulation and intracoporeal knot tying were improved significantly after the training course (46.9 ± 5.3 vs 29.5 ± 9.4, P < .001), the improvement rate was 59%. No statistically significant correlations were observed between intracorporeal laparoscopic suturing skills and proficiency in the basic laparoscopic manipulative skills assessed before (r = 0.193; P = 0.149) and after (r = 0.024; P = 0.857) the training course. 91% of senior trainees and 94% junior trainees expressed that intracorporeal suturing should be introduced at an early stage of the training curriculum.

CONCLUSIONS

There was no statistically significant correlation between the performance on basic operative laparoscopic skills (non-suturing skills) and laparoscopic suturing skills observed in this study. The acquisition of basic laparoscopic skills is not a prerequisite for training in intracorporeal suturing and it may be beneficial for the surgical trainees to learn this skill early in the surgical training curriculum. Surgical trainees want to learn and practice laparoscopic suturing earlier than later in their training.

摘要

背景

本研究的目的是探讨腹腔镜缝合技能的获得与其他手术腹腔镜技能之间的关系,并为确定引入腹腔镜缝合训练的理想时间和持续时间提供证据。

方法

研究的第一部分探讨了腹腔镜缝合技能的获得与其他手术腹腔镜技能熟练程度之间的关系。研究的第二部分包括高级和初级学员对腹腔镜缝合培训方面的意见调查。

结果

共有 128 名外科学员参加了这项研究。57 名高级外科学员的腹腔镜缝合技能(包括针操作和腔内打结)的任务表现总评分在培训课程后显著提高(46.9±5.3 与 29.5±9.4,P<0.001),提高率为 59%。在培训课程前后,腔内腹腔镜缝合技能与基本腹腔镜操作技能的熟练程度之间均无统计学显著相关性(评估前 r=0.193;P=0.149,评估后 r=0.024;P=0.857)。91%的高级学员和 94%的初级学员表示,腔内缝合应该在培训课程的早期阶段引入。

结论

在本研究中,基本手术腹腔镜技能(非缝合技能)的表现与腹腔镜缝合技能之间没有统计学显著相关性。基本腹腔镜技能的获得不是腔内缝合训练的先决条件,对于外科学员来说,在外科培训课程的早期学习这一技能可能是有益的。外科学员希望在培训的早期而不是晚期学习和练习腹腔镜缝合。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f835/7059355/24e1208c9669/12909_2020_1986_Fig1_HTML.jpg

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