Faculty of Medicine, Department of Gastroenterological Surgery II, Hokkaido University, Kita 15, Nishi 7, Kita-Ku, Sapporo, 060-8638, Japan.
Department of Pediatric Surgery, Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo, Japan.
Surg Endosc. 2023 Aug;37(8):6408-6416. doi: 10.1007/s00464-023-09975-y. Epub 2023 Mar 22.
Pediatric endoscopic surgery has become an alternative to conventional techniques with the development of medical equipment. However, there is no formal, standardized curriculum for pediatric endoscopic surgery, and its requirement remains elusive. The purpose of this study is to determine the baseline knowledge of pediatric surgeons that is considered essential for pediatric laparoscopic and thoracoscopic surgery.
Sixteen web-based multiple-choice questions based on the fundamental cognitive knowledge of pediatric endoscopic surgery were administered. The questions were created based on the fields covered by the Fundamentals of Laparoscopic Surgery ™ (FLS) certification examination blueprints and eight specific diseases of pediatric surgery. Pediatric surgeons and pediatric surgical trainees participated in this study voluntarily.
A total of 122 surgeons participated through the Japanese Society of Pediatric Surgeons. The response rate was 95% (122/128). The total mean examination score of all participants was 79.4% (77.3-81.4%). There were no significant differences in total scores between the board-certified pediatric surgeons without an endoscopic surgical skill qualification and the non-board-certified pediatric surgeons (80.4% vs. 77.1%, p = 0.12). The endoscopic surgical skill-qualified surgeons had significantly higher percentages of correct responses in specific subjects than board-certified pediatric surgeons and surgeons without pediatric board certification (94.3% vs. 82.9%, p = 0.02; 94.3% vs. 77.5%, p = 0.0002). The FLS original subjects' scores were not significantly different among them. The mean score of surgeons who had experienced more than 200 cases of endoscopic surgery, including adult cases, was 83.2% (80.4-85.9%).
A knowledge gap exists between surgeons, board-certified pediatric surgeons, and endoscopic surgical skill-qualified surgeons in Japan. In the field of pediatric surgery, an effective formal curriculum, such as FLS, is required to help address this vast knowledge gap for the safe conduct of endoscopic surgeries.
随着医疗设备的发展，小儿内镜外科已成为传统技术的替代方法。然而，小儿内镜外科尚无正式的标准化课程，其要求仍不明确。本研究旨在确定小儿外科医师认为小儿腹腔镜和胸腔镜手术所必需的基本理论知识。
根据腹腔镜手术基础（FLS）认证考试蓝图和小儿外科的八个特定疾病领域，共设计了 16 个基于小儿内镜外科基础知识的网络多项选择题。小儿外科医师和小儿外科实习医师自愿参加了这项研究。
共有 122 名外科医师通过日本小儿外科学会参与了这项研究。应答率为 95%（122/128）。所有参与者的总平均考试得分为 79.4%（77.3-81.4%）。具有内镜手术技能资格的小儿外科医师与未获得内镜手术技能资格的小儿外科医师之间的总得分没有显著差异（80.4%比 77.1%，p=0.12）。具有内镜手术技能资格的外科医师在特定科目上的正确答案比例明显高于小儿外科医师和未获得小儿外科委员会认证的外科医师（94.3%比 82.9%，p=0.02；94.3%比 77.5%，p=0.0002）。他们的 FLS 原始科目分数没有显著差异。具有 200 例以上内镜手术经验（包括成人病例）的外科医师的平均得分为 83.2%（80.4-85.9%）。
日本的外科医师、小儿外科医师和具有内镜手术技能资格的外科医师之间存在知识差距。在小儿外科领域，需要一种有效的正式课程，如 FLS，以帮助解决这一巨大的知识差距，确保内镜手术的安全进行。
