Udwadia Tehemton Erach
Center of Excellence for Minimal Access Surgery Training; Department of Surgery, Grant Medical College, Grant Medical College and J.J. Hospital; Department of Surgery, B. D. Petit Parsee General Hospital, Breach Candy Hospital, Mumbai, Maharashtra, India.
J Minim Access Surg. 2021 Apr-Jun;17(2):180-187. doi: 10.4103/jmas.JMAS_86_20.
Laparoscopic colorectal surgery (LCRS) was first described in 1991, and its safety, efficacy and patient benefit were adequately documented in literature. However, its penetration and acceptability is poor in most countries, due to its long learning curve and lack of surgeons training and confidence. A Minimal Access Surgery (MAS) Training Center in Mumbai has over the last 7 years trained more than 8000 surgeons in various MAS specialities. The centre has initiated courses for LCRS training.
The anatomy of the pig colon is very different from human anatomy. The pig colon anatomy is altered to mimic human colon anatomy in the porcine abdomen, permitting hands-on practice on most laparoscopic colorectal surgical procedures, as part of the LCRS training course, under mentorship of expert faculty, who simultaneously assess participants performance.
Each participant performs and assists for at least three procedures and is evaluated at each step of the procedure by a structured format. The overall evaluation by Faculty which though subjective, is detailed and favourable. Feedback of each participant is good and acceptable as a very helpful course.
This porcine model is ideal for hands-on training for LCRS. Participants achieve a good degree of skill level and confidence in performing LCRS procedures on fresh bleeding porcine cadaver models. The centre is factual and pragmatic and stresses that it needs more than a course to make a safe surgeon; operation room mentorship is the finishing school.
腹腔镜结直肠手术（LCRS）于1991年首次被描述，其安全性、有效性及对患者的益处已在文献中得到充分记载。然而，由于其学习曲线长且缺乏外科医生培训及信心，在大多数国家其普及程度和可接受性较差。孟买的一个微创外科（MAS）培训中心在过去7年里已对8000多名外科医生进行了各种MAS专业培训。该中心已启动LCRS培训课程。
猪结肠的解剖结构与人类解剖结构有很大不同。在猪腹部改变猪结肠的解剖结构以模拟人类结肠解剖结构，作为LCRS培训课程的一部分，在专家教员的指导下，允许对大多数腹腔镜结直肠手术进行实践操作，同时专家教员评估参与者的表现。
每位参与者至少执行并协助进行三项手术，并在手术的每个步骤通过结构化形式进行评估。教员的总体评估虽然主观，但详细且积极。每位参与者的反馈都很好，认为该课程非常有帮助且可以接受。
这种猪模型是LCRS实践培训的理想选择。参与者在新鲜出血的猪尸体模型上进行LCRS手术时达到了较高的技能水平和信心。该中心实事求是且注重实际，强调要培养一名安全的外科医生需要的不仅仅是一门课程；手术室指导才是完善培训。
