2007, Number 3
<< Back Next >>
Rev Mex Cir Pediatr 2007; 14 (3)
Development of craft surgical endoscopica: When does it occur the transition from beginner to advanced in a simulator physical? Pilot Study
Porras-Hernández JD, Nieto-Zermeño J, Bracho-Blanchet E, Ordorica-Flores R, Porras-Hernández LH, Trujillo-Ponce A, Teyssier-Morales G, Minor-Martínez A, Lorías-Espinoza D, Pantoja-Millán JP, Lezama-del Valle P
Language: Spanish
References: 25
Page: 117-125
PDF size: 614.07 Kb.
ABSTRACT
Introduction: The purpose of this study was to determine the transition in the laparoscopic skills of novice surgeons to the level of advanced surgeons using validated drills in a training box.
Materials and methods: A quasi-experimental study of 10 pediatric surgical residents was designed. Residents with previous endoscopic surgical experience equal to or less than five laparoscopic procedures were included. They repeated the MISTELS, Southwestern and García-Ruiz drills untilthe achievement of a validated performance score for advanced surgeons in 5 consecutive repetitions.
Results: The studied group required 12 ± 9 (2-60) repetitions to achieve the specified performance score in the whole set of drills. For the intracorporeal knotting drill they required 11 ± 4 (2-34) repetitions, having a time improvement from 155 to 61 seg (p=0.01); for the extracorporal knotting drill, they required16 ± 7 (4-29) repetitions, with a time improvement from 117 to 46 seg (p=0.002); and for the continuous intracorporeal suture, they required 14 ± 6 (2-23) repetitions and a timing from 559 to 180 seg (p=0.002).
Conclusion: After a mean of 12 repetitions, our residents developed skills that Hill probable improve patients security in their first laparoscopic procedures in children.
REFERENCES
Derossis AM, Fried GM, Abrahamowicz M, Sigman HH, Barkun JS, Meakins JL. Development of a model for training and evaluation of laparoscopicskills. Am J Surg 1998; 175: 482-487.
Gallagher AG, Ritter EM, Champion H, et al. Virtual reality simulation for the operating room. Proficiency-based training as a paradigm shift in surgical skills training. Ann Surg 2005; 241: 364- 372.
Aggarwal R, Moorthy K, Darzi A. Laparoscopic skills training and assessment. Br J Surg 2004; 91: 1549-1558.
Seymour NE, Gallagher AG, Roman SA, etal. Virtual reality training improves operating room performance. Results of a randomized, doubleblinded study. Ann Surg 2002; 236: 458- 464.
Youngblood PL, Srivastava S, Curet M, Heinrichs WL, Dev P, Wren SM. Comparison of training on two laparoscopic simulators and assessment of skills transfer to surgical performance. J Am Coll Surg 2005; 200: 546- 551.
Korndorffer JRJr, Stefainidis D, Scott DJ. Laparoscopic skills laboratories: current assessment and a call for resident training standards. Am J Surg 2006; 191: 17-22.
Stefanidis D, Korndorffer JRJr, Sierra R, Touchard C, Dunne B, Scott DJ. Skill retention following proficiency-based laparoscopic simulator training. Surgery 2005; 138: 165-170.
Peters JH, Fried GM, Swanstrom LL, et al. Development and validation of a comprehensive program of education and assessment of the basic fundamentals of laparoscopic surgery. Surgery 2004; 135: 21-27.
Fried GM, Feldman LS, Vassiliou MC, et al. Proving the value of simulation in laparoscopic surgery. Ann Surg 2004; 240: 518-528.
Korndorffer JRJr, Clayton JL, Tesfay ST, et al. Multicenter construct validity for Southwestern laparoscopic videotrainer stations. J Surg Res 2005; 128: 114-119.
Lawden MC. An investigation of the ability of the human visual system to encode spatial phase relations. Vision Res 1983; 23: 457- 467.
Ekstrom RB, French JW, Harman HH, Dermen D. Manual for kit of factor-referenced cognitive tests. Princeton NJ: Educational Testing Service, 1976.
Peters M, Laeng B, Latham K, Jackson M, Zaiyouna R, Richardson C. A redrawn Vandenburg and Kuse mental rotations test: different versions and factors that affect performance. Brain Cogn 1995; 28: 39- 58.
Murphy SM, Tyler S. The relationship between learning approaches to part-time studyof management courses and transfer of learning to the workplace. Educational Psychology 2005; 25: 455-469.
Garcia-Ruiz A, Gagner M, Millar J, Steiner CP, Hahn JF. Manual vs. robotically assisted laparoscopic surgery in the performance of basic manipulation and suturing tasks. Arch Surg 1998; 133: 957-961.
Rogers CA, Reeves BC, Caputo M, Ganesh JS, Bonser RS, Angelini GD. Control chart methods for monitoring cardiac surgical performance and their interpretation. J Thorac Cardiovasc Surg 2004; 128: 811-819.
Williams SM, Parry BR, Schlup MMT. Quality control: an application of the CUSUM. BMJ 1992; 304: 1359-1361.
Spencer FC. Teaching and measuring surgical techniques. The technical evaluation of competence. Bull Am Coll Surg 1978; 63: 9-12.
Dagash H, Chowdhury M, Pierro A. When can I be proficient in laparoscopic surgery? A systematic review of the evidence. J Pediatr Surg 2003; 38: 720- 724.
Kohn LT, Corrigan JM, Donaldson MS. To err is human. Building a safer health system. Washington, D.C.: National Academy Press, 2000; pp. 155- 201.
Fraser SA, Feldman LS, Stanbridge D, Fried GM. Characterizing the learning curve for a basic laparoscopic drill. Surg Endosc 2005; 19: 1572-1578.
Rosser JC, Rosser LE, Savalgi RS. Skill acquisition and assessment for laparoscopic surgery. Arch Surg 1997; 132: 200-204.
Brunner WC, Korndorffer JRJr, Sierra R, et al. Laparoscopic virtual reality training: are 30 repetitions enough? J Surg Res 2004; 122: 150-156.
Grantcharov TP, Bardram L, Funch-Jensen P, Rosenberg J. Learning curves and impact of previous operative experience on performance on a virtual reality simulator to test laparoscopic surgical skills. Am J Surg 2003; 185: 146-149.
Gallagher AG, Ritter EM, Satava RM. Fundamental principles of validation, and reliability: rigorous science for the assessment of surgical education and training. Surg Endosc 2003; 17: 1525-1529.