Zucker K A, Bailey R W, Graham S M, Scovil W, Imbembo A L
Department of Surgery, University of Maryland School of Medicine, Baltimore.
World J Surg. 1993 Jan-Feb;17(1):3-7. doi: 10.1007/BF01655696.
Laparoscopic cholecystectomy has rapidly become the procedure of choice for most patients with symptomatic gallbladder disease. Laparoscopic surgery, however, has not been a required component of most general surgery training programs. The demonstrated efficacy of laparoscopic surgery dictates that this discipline be rapidly incorporated into residency programs. Laparoscopic cholecystectomy and other surgical endoscopic procedures have been an integral part of the training program at the University of Maryland since 1989. Currently, residents who are completing their training have performed on average 50 to 75 laparoscopic procedures as the primary surgeon and 25 to 30 as the first assistant. In addition to training future community and academic physicians, those surgeons currently in practice must receive appropriate instruction in laparoscopic surgery. Most practicing surgeons attend a 2- to 3-day intensive course offering both didactic and hands-on experience. Additional exposure to clinical cases is achieved by working with other surgeons with laparoscopic expertise. Full credentialing in laparoscopic cholecystectomy generally requires proctoring by a surgeon from the local community. Since 1990 faculty from the University of Maryland have been active in the local community serving as proctors to surgeons in 14 hospitals.
腹腔镜胆囊切除术已迅速成为大多数有症状胆囊疾病患者的首选手术方式。然而，腹腔镜手术并非大多数普通外科培训项目的必修内容。腹腔镜手术已被证实的疗效表明，这一学科应迅速纳入住院医师培训项目。自1989年以来，腹腔镜胆囊切除术及其他外科内镜手术一直是马里兰大学培训项目的重要组成部分。目前，即将完成培训的住院医师作为主刀医生平均已进行了50至75例腹腔镜手术，作为第一助手进行了25至30例。除了培训未来的社区和学术医生外，目前仍在执业的外科医生也必须接受腹腔镜手术的适当指导。大多数执业外科医生会参加一个为期2至3天的强化课程，该课程既有理论教学又有实践经验。通过与其他有腹腔镜专业知识的外科医生合作，可以增加临床病例的接触机会。腹腔镜胆囊切除术的全面认证通常需要当地社区的一名外科医生进行监考。自1990年以来，马里兰大学的教员一直活跃于当地社区，为14家医院的外科医生担任监考员。
