Department of Obstetrics and Gynecology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
Department of Emergency, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
ANZ J Surg. 2022 Sep;92(9):2102-2108. doi: 10.1111/ans.17819. Epub 2022 Jun 16.
Because of special technical challenges, laparoendoscopic single-site surgery (LESS) has been introduced into surgical practice, with surgeons required to have adequate training. The COVID-19 pandemic has significantly affected every aspect of healthcare systems, including LESS training, which must be modified to minimize the impact of the COVID-19 pandemic.
A 3-session training programme was designed in 2020 during the epidemic, which was modified in 2019 before the pandemic. Session 1 was an online study on LESS knowledge. Session 2 involved the trainees' self-directed simulator-training. Task performance was evaluated using the fundamentals of laparoscopic surgery (FLS) scoring. Session 3 was practical training, including trainers' live surgical video demonstrations and trainees' surgical video feedback after training. Video feedback performance was evaluated using the modified global rating scale (GRS). Furthermore, trainees completed a general self-efficacy (GSE) instrument. Forty-two gynaecology trainees were allocated into two groups: novices (n = 32) and experts (n = 10).
Compared with pre-training, FLS scores improved in peg transfer (P < 0.001 and P = 0.01) and pattern cutting (P = 0.02 and P < 0.001) for novices and experts, respectively. Participants (81% versus 67%) provided first and second video feedback, respectively. Compared to the first feedback, the GRS scores of both groups improved significantly in the second feedback. All trainees showed an increase in GSE after training (P < 0.001).
The modified LESS training programme is a practical and effective option that allows trainees to continue training during the epidemic.
由于特殊的技术挑战，经脐单孔腹腔镜手术（LESS）已被引入外科实践，外科医生需要接受足够的培训。COVID-19 大流行极大地影响了医疗保健系统的各个方面，包括 LESS 培训，必须对其进行修改，以将 COVID-19 大流行的影响降至最低。
2020 年疫情期间设计了一个 3 个阶段的培训计划，该计划在大流行前的 2019 年进行了修改。第 1 阶段是 LESS 知识的在线学习。第 2 阶段涉及学员的自我指导模拟器训练。使用腹腔镜手术基础（FLS）评分评估任务表现。第 3 阶段是实际培训，包括培训师的现场手术视频演示和学员培训后的手术视频反馈。使用改良的全球评分量表（GRS）评估视频反馈表现。此外，学员完成了一般自我效能感（GSE）工具。42 名妇科学员被分为两组：新手（n=32）和专家（n=10）。
与培训前相比，新手的 peg 转移（P<0.001 和 P=0.01）和模式切割（P=0.02 和 P<0.001）的 FLS 评分均有所提高，专家的 peg 转移（P<0.001 和 P=0.02）和模式切割（P<0.001 和 P=0.02）的 FLS 评分也有所提高。学员分别提供了第一和第二视频反馈（81%和 67%）。与第一反馈相比，两组的 GRS 评分在第二反馈中均显著提高。所有学员在培训后 GSE 均有所增加（P<0.001）。
改良的 LESS 培训计划是一种实用且有效的选择，允许学员在疫情期间继续接受培训。
