medigraphic.com

2013, Number 5

<< Back Next >>

Cir Cir 2013; 81 (5)

Pyramid training model in laparoscopic surgery

Usón-Gargallo J, Pérez-Merino EM, Usón-Casaús JM, Sánchez-Fernández J, Sánchez-Margallo FM

Language: Spanish
References: 42
Page: 420-430
PDF size: 383.28 Kb.


ABSTRACT

Background: Minimally invasive surgery implementation requires a regulated and orderly learning process.
Methods: Jesús Usón Minimally Invasive Surgery Centre promotes a pyramid training model structured into four levels: training of basic and advanced skills in physical simulator (level 1), training of anatomical protocols and advanced skills with animal models (level 2) training advanced procedural skills with tele-surgical applications (level 3), and training in the operating room (level 4). Training provided at levels 1 and 2 is described and evaluated.
Results: 4284 participants have been trained in laparoscopy at our institution. 95.5% surgeons: 49% gastroenterologists, 30% urologists, and 14% gynecologist (14%). 77% of celebrated courses consisted of 20 hours training (8 at level 1 and 12 at level 2). 94.37% of participants considered pyramid model as highly suitable, scoring 9.5 on a scale 1-10 for the model and for the simulation quality. 82.7% perceived the improvement in their laparoscopic skills and 99.56% recommend this training program to other surgeons.
Discussion: There are no unified criteria between different training programs but most of them measure laparoscopic skills based on time of execution, quality or mistakes of the exercise, and the student satisfaction test.
Conclusion: The pyramid training model lead to the acquisition of necessary laparoscopic skills to perform safely advanced minimally invasive techniques.


REFERENCES

  1. Delgado F, Gómez-Abril S, Montalvá E, Torres T, Martí E, Trullenque R, et al. Formación del residente en cirugía laparoscópica: un reto actual. Cir Esp 2003;74:134-138.

  2. Usón J, Sánchez FM, Pascual S, Climent S. Formación en cirugía laparoscópica paso a paso. 4ª ed. Cáceres: Editorial Centro de Cirugía de Mínima Invasión Jesús Usón, 2010;27-28.

  3. Prinz RA. Education, economics and excellence. Arch Surg 2004;139:469-475.

  4. te Velde EA, Bax NMA, Tytgat SHAJ, de Jong JR, Travassos DV, Kramer WLM, et al. Minimally invasive pediatric surgery: Increasing implementation in daily practice and resident’s training. Surg Endosc 2008;22:163-166.

  5. Asano TK, Soto C, Poulin EC, Mamazza J, Boushey RP. Assessing the impact of a 2-day laparoscopic intestinal workshop. Can J Surg 2011;54:223-226.

  6. van Velthoven RF, Piechaud PT. Training Centers: An Essential Step to Developing Skills in Urolaparoscopic. Curr Urol Rep 2009;10:93- 96.

  7. González R, Bowers SP, Smith CD, Ramshaw BJ. Does setting specific goals and providing feedback during training results in better acquisition of laparoscopic skills? Am Surg 2004;70:35-39.

  8. Enciso S, Sánchez FM, Díaz Güemes I, Usón J. Validación preliminar del simulador físico Simulap® y de su sistema de evaluación para cirugía laparoscópica. Cir Esp 2012;90:38-44.

  9. Sánchez-Margallo FM, Lucas M, Pagador JB, Pérez-Duarte FJ, Sánchez-Margallo JA, Castelló P, et al. Effects of the design of laparoscopic tool handle in ergonomic assessment of the upper limb. Minim Invas Therapy Allied Technol 2010;19:28-28.

  10. Sánchez-Margallo FM, Sánchez-Margallo JA, Pagador JB, Moyano JL, Moreno J, Usón J. Ergonomic Assessment of Hand Movements in Laparoscopic Surgery Using the CyberGlove®. Comput Biom Med 2010;2:121-128.

  11. Pérez-Duarte FJ, Sánchez-Margallo FM, Díaz-Güemes MPI, Sánchez-Hurtado MÁ, Lucas-Hernández M, Usón-Gargallo J. Ergonomics in laparoscopic surgery and its importance in surgical training. Cir Esp 2012;90:284-291.

  12. Birch DW, Bonjer HJ, Crossley C, Burnett G, de Gara C, Gomes A, et al. Canadian consensus conference of the development of training and practice standards in advanced minimally invasive surgery. Can J Surg 2009;52:321-327.

  13. Oropesa I, Sánchez-González P, Lamata P, Chmarra MK, Pagador JB, Sánchez-Margallo JA, et al. Methods and Tools for Objective Assessment of Psychomotor Skills in Laparoscopic Surgery. J Surg Res 2011;171:e81-e95.

  14. Park AE, Witzke D. The surgical competence conundrum. Surg Endosc 2002;16:555-557.

  15. Satava RM, Cuschieri A, Hamdorf J. Metrics for objective assessment. Surg Endosc 2003;17:220-226.

  16. Risuci DA, Wolfe KC, Kaul A. Promoting Self-Efficacy in Minimally Invasive Surgery Training. JSLS 2009;13:4-8.

  17. Gould JC. Building a Laparoscopic Surgical Skills Training Laboratory: Resources and Support. JSLS 2006;10:293-296.

  18. Rodríguez-García JI, Turienzo-Santos E, Vigal-Brey G, Brea-Pastor A. Formación quirúrgica en simuladores en centros de entrenamiento. Cir Esp 2006;79:342-348.

  19. de Wilde RL, Hucke J, Kolmorgen K, Tinnenberg H, Gynecologic Endoscopy Working Group of the German Society of Obstetrics and Ginecology. Recomendations by the gynecologic endoscopy working group of the german society of obstetrics and gynecology for the advancement of training and education in minimal-access surgery. Arch Gynecol Obstet 2011;283:509-512.

  20. Van Dongen KW, Ahlberg G, Bonavina L, Carter FJ, Grantcharov TP, Hyltander A, et al. European consensus on a competencybased virtual reality training program for basic endoscopic surgical psychomotor skills. Surg Endosc 2011;25:166-171.

  21. Berg DA, Milner RE, Fisher CA, Goldberg AJ, Dempsey DT, Gewal H. A cost-effective approach to establishing a surgical skills laboratory. Surgery 2007;142:712-721.

  22. Subhas G, Mittal VK. Minimally Invasive Training During Surgical Residency. Am Surg 2011;77:902-906.

  23. Edelman DA, Mattos MA, Bouwman DL. FLS Skill Retention (Learning) in First Year Surgery Residents. J Surg Res 2010;163:24-28.

  24. Edelman DA, Mattos MA, Bouwman DL. Impact of Fundamentals of Laparoscopic Surgery Training During Medical School on Performance by First Year Surgical Residents. J Surg Res 2011;170: 6-9.

  25. Rooney DM, Santos BF, Hungness ES. Fundamentals of Laparoscopic Surgery (FLS) Manual Skills Assessment: Surgeon vs Nonsurgeon Raters. J Surg Educat 2012;69:588-592.

  26. Swanstrom LL, Fried GM, Hoffman KI, Soper NJ. Beta Test Results of a New System Assessing Competence in Laparoscopic Surgery. J Am Coll Surg 2006;202:62-69.

  27. Ritter EM, Scott DJ. Design of a Proficiency-Based Skills Training Curriculum for the Fundamentals of Laparoscopic Surgery. Surg Innov 2007;14:107-112.

  28. Scott DJ, Ritter EM, Tesfay ST, Pimentel EA, Nagji A, Fried GM. Certification pass rate of 100% for fundamentals of laparoscopic surgery skills after proficiency-based training. Surg Endosc 2008;22:1887-1993.

  29. Zheng B, Hur HC, Johnson S, Swanström LL. Validity of using Fundamentals of Laparoscopic Surgery (FLS) program to asses laparoscopic competence for gynecologist. Surg Endosc 2010;24:152-160.

  30. Manuel-Palazuelos JC, Alonso-Martín J, Rodríguez-Sanjuan JC, Fernández-Díaz MJ, Gutiérrez-Cabezas JM, Revuelta-Álvarez S, et al. Programa de formación del residente de cirugía en un laboratorio experimental de cirugía mínimamente invasiva (CENDOS). Cir Esp 2009;85:84-91.

  31. Sarker SK, Hutchinson R, Chang A, Vincent C, Darzi AW. Selfappraisal hierarchial task analysis of laparoscopic surgery performed by expert surgeons. Surg Endosc 2006;20:636-640.

  32. Hamad MA, Mentges B, Buess G. Laparoscopic sutured anastomosis of the bowel. Technique and learning curve. Surg Endosc 2003;17:1840-1844.

  33. Hur HC, Arden D, Dodge LE, Zheng B, Ricciotti HA. Fundamentals of Laparoscopic Surgery: A Surgical Skills Assessment Tool in Gynecology. J Society Laparoendoscop Surg 2011;15:21-26.

  34. Sroka F, Feldman LS, Vassiliou MC, Kaneva PA, Fayez R, Fried GM. Fundamentals of Laparoscopic Surgery simulator training to proficiency improves laparoscopic performance in the operating room- a randomized controlled trial. Am J Surg 2010;199:115- 120.

  35. Stefanidis D, Arora S, Parrack DM, Hamad GG, Capella J, Grantcharov T, et al. Research priorities in surgical simulation for de 21st century. Am J Surg 2012;203:49-53.

  36. Montoya-Chinchilla R, Campillo-Soto Á, Pietricica B, Cano- García MC, Hidalgo-Agulló G, García-Marín JA. Entrenamiento laparoscópico de bajo costo: tiempo de entrenamiento necesario para adquirir habilidades laparoscópicas básicas similares a las de un experto. Cir Cir 2012;80:253-260.

  37. Asano TK, Soto C, Poulin EC, Mamazza J, Boushey RP. Assessing the impact of a 2-day laparoscopic intestinal workshop. Can J Surg 2011;54:223-226.

  38. Arredondo Merino RR, Gallardo Valencia LE. Uso de simuladores para la capacitación de médicos residentes. Ginecol Obstet Mex 2012;80:400-408.

  39. Herrera FA, Easter DW. Minimally invasive surgery: training in resident education. Current Surg 2006;63:166-169.

  40. Thijssen AS, Schijven MP. Contemporary virtual reality laparoscopy simulators: quicksand or solid grounds for assessing surgical trainees? Am J Surg 2010;199:529-541.

  41. Fried GM, Feldman LS. Objective Assessment of Technical Performance. World J Surg 2008;32:156-160.

  42. Cuschieri A. La cirugía laparoscópica en Europa: ¿hacia dónde vamos? Cir Esp 2006;79:10-21.




2020     |     www.medigraphic.com