Bidault-Jourdainne Valeska, Breaud Jean, Ali Liza, Talon Isabelle, Becmeur François, Ghoneimi Alaa El, Peycelon Matthieu
Urovisceral Paediatric Surgery Department, HFME, Civil Hospices of Lyon, Lyon, France.
Simulation Platform iLumens Diderot, Paris Cité University, Paris, France.
BMC Med Educ. 2024 Dec 2;24(1):1408. doi: 10.1186/s12909-024-06346-6.
Mastering paediatric laparoscopic surgery competency (PLSC) is technically challenging. The present study aimed to determine whether the inter-academic PLSC degree (IAD_PLSC) practical training program enables trainees to improve their skills.
This retrospective study included trainees enrolled in the IAD_PLSC program in 2021 and 2022 which included two separate 12 h-sessions. Trainees practiced to perform intracorporeal laparoscopic knots (ILK) using 5- and 3-mm instruments on a pelvi-trainer simulator; Peg Transfer (PT) was used as a dexterity test; final marks added the adapted Objective Structured Assessment of Technical Skills (OSATS) score (out of 40) and time to complete ILK. ILK was considered a success in case the OSATS score > 27/40.
A total of 43 trainees completed the IAD_PLSC program. N = 37 (86.0%) mastered the ILK (OSATS score > 27/40) using 5-mm instruments at the end of session 1 and N = 33 (76.7%) at the end of session 2 (p = 0.41). There was no significant improvement in the median [interquartile range, IQR] OSATS score (32 [30-36] vs. 32 [28-34], p = 0.19), but the median [IQR] knot completion time improved significantly (184 s [161-268] vs. 166 s [128-218], p = 0.002). There was a significant correlation between the knot completion time and PT time at the end of session 1 (ρ = 0.58, 95% confidence interval, CI [0.31;0.76], p < 0.0002) and session 2 (ρ = 0.78, 95%CI [0.62;0.87], p < 0.0001). When using 3-mm instruments, N = 34 (79.1%) of trainees mastered the ILK at the end of session 2. The median [IQR] OSATS score significantly improved between the end of the two sessions (22 [21-24] vs. 31 [28-33], p < 0.0001), but there was no significant correlation between OSATS score or knot completion time and PT time, at the end of both sessions.
A nation-wide training program in paediatric laparoscopic surgery provides valuable practical training of intracorporeal suturing for residents in pediatric surgery and urology.
掌握小儿腹腔镜手术技能（PLSC）在技术上具有挑战性。本研究旨在确定学术间PLSC学位（IAD_PLSC）实践培训项目是否能使学员提高技能。
这项回顾性研究纳入了2021年和2022年参加IAD_PLSC项目的学员，该项目包括两个独立的12小时课程。学员们在骨盆训练模拟器上使用5毫米和3毫米器械练习进行体内腹腔镜打结（ILK）；使用钉转移（PT）作为灵巧性测试；最终成绩加上改编后的客观结构化技术技能评估（OSATS）分数（满分40分）和完成ILK的时间。如果OSATS分数>27/40，则认为ILK成功。
共有43名学员完成了IAD_PLSC项目。在第1阶段结束时，N = 37（86.0%）的学员使用5毫米器械掌握了ILK（OSATS分数>27/40），在第2阶段结束时，N = 33（76.7%）的学员掌握了ILK（p = 0.41）。OSATS分数的中位数[四分位间距，IQR]没有显著提高（32 [30 - 36] 对 32 [28 - 34]，p = 0.19），但打结完成时间的中位数[IQR]显著改善（184秒 [161 - 268] 对 166秒 [128 - 218]，p = 0.002）。在第1阶段结束时，打结完成时间与PT时间之间存在显著相关性（ρ = 0.58，95%置信区间，CI [0.31;0.76]，p < 0.0002），在第2阶段结束时也存在显著相关性（ρ = 0.78，95%CI [0.62;0.87]，p < 0.0001）。当使用3毫米器械时，在第2阶段结束时，N = 34（79.1%）的学员掌握了ILK。两个阶段结束时，OSATS分数的中位数[IQR]显著提高（22 [21 - 24] 对 31 [28 - 33]，p < 0.0001），但在两个阶段结束时，OSATS分数或打结完成时间与PT时间之间均无显著相关性。
一项全国性的小儿腹腔镜手术培训项目为小儿外科和泌尿外科住院医师提供了有价值的体内缝合实践培训。
