Pediatric Surgery Unit, Department of Translational Medical Science, University of Naples "Federico II," Naples, Italy.
J Laparoendosc Adv Surg Tech A. 2021 May;31(5):594-597. doi: 10.1089/lap.2020.0826. Epub 2021 Apr 26.
The development of integrated multimedia operating rooms has made possible to record surgical procedures mainly in minimally invasive surgery (MIS) and robotic surgery. This modality of video storage allows the trainees to study surgical procedures based on video analysis. The aim of this study is to compare two learning methods of surgical procedures, operative textbooks and video-based coaching, in a group of 10 pediatric surgery trainees. We selected five surgical procedures to study: three MIS procedures, Nissen fundoplication, partial nephrectomy, and cholecystectomy; and two robotic procedures, Lich-Gregoir reimplantation for vesicoureteral reflux and Henderson-Hynes pyleoplasty for ureteropelvic junction obstruction. Ten trainees were divided into two groups of 5 each, Group 1 (G1) and Group 2 (G2). G1 studied the procedures analyzing videos, G2 studied the same procedure classically reading textbooks. Tutors prepared a questionnaire of 100 multianswered questions that was submitted to both groups, divided into 20 questions for each surgical technique. The questionnaire focused on the different steps of surgical techniques. Analyzing the 10 questionnaires, G1 (video group) obtained a median result of 82 exact answers (74-97), whereas G2 (textbook group) obtained a median result of 64.2 correct answers (53-79). Analyzing statistically the results of two groups, using unpaired -Student's test with a level of statistical significance >95%, the results of G1 were statistically significantly better that G2 with a = .0265 for the average scores. Video-based coaching to learn surgical techniques is a novel, feasible, and excellent modality for supplementing surgical techniques learning for pediatric surgery trainees. Objective evaluation using a multianswered questionnaire demonstrates that video-based coaching in pediatric surgery is statistically better than textbook classic education. We suggest to adopt this teaching modality in every surgical training program above all to teach MIS and robotic surgery.
多媒体一体化手术室的发展使得对微创手术（MIS）和机器人手术中的手术过程进行记录成为可能。这种视频存储方式可以使学员通过视频分析来学习手术过程。本研究旨在比较两种手术方法的学习方法，即手术教科书和基于视频的指导，在一组 10 名儿科外科实习医生中进行。 我们选择了 5 种手术进行研究：3 种 MIS 手术，Nissen 胃底折叠术、部分肾切除术和胆囊切除术；2 种机器人手术，Lich-Gregoir 膀胱输尿管反流再植入术和 Henderson-Hynes 肾盂成形术治疗肾盂输尿管交界处梗阻。10 名实习医生分为两组，每组 5 人，第 1 组（G1）和第 2 组（G2）。G1 通过分析视频学习手术，G2 则通过经典阅读教科书学习同一手术。导师准备了一份 100 道多项选择题的问卷，分别分发给两组，每组 20 道题。问卷重点关注手术技术的不同步骤。 分析 10 份问卷，G1（视频组）获得 82 个正确答案（74-97）的中位数，而 G2（教科书组）获得 64.2 个正确答案（53-79）的中位数。使用独立样本 -Student 检验对两组结果进行统计学分析，统计学显著性水平>95%，G1 的结果明显优于 G2，平均分数为 = .0265。 基于视频的指导学习手术技术是一种新颖、可行的方法，可以补充儿科外科实习医生的手术技术学习。使用多项选择题的客观评估表明，儿科手术中的基于视频的指导在统计学上优于经典教科书教育。我们建议在所有外科培训计划中采用这种教学模式，尤其是教授 MIS 和机器人手术。
