- 作者：Juan Carlos Rodrí ; guez-Sanjuá ; n ; cgdrsj@humv.es ; Carlos Manuel-Palazuelos ; Marí ; a José ; Ferná ; ndez-Dí ; ez ; José ; Manuel Gutié ; rrez-Cabezas ; Joaquí ; n Alonso-Martí ; n ; Carlos Redondo-Figuero ; Luis Antonio Herrera-Noreñ ; a ; Manuel Gó ; mez-Fleitas
- 关键词：Entrenamiento laparoscó ; pico ; Endotrainer ; Anastomosis intestinales
- 刊名：Cirug铆a Espa帽ola
- 出版年：2010
- 期刊代码：pca87_0009739X
- 类别：med
- 出版时间：January 2010
- 卷：87
- 期：1
- 页码：20-25
- 文件大小：191 K
Background
The complexity of laparoscopic surgery makes specific training out of the operating rooms necessary to shorten learning curves and to minimise morbidity rates. Our aim was to analyse the increase in laparoscopic skills after completion of a laboratory training program.
Material and methods
Prospective study of surgical resident training based on anastomosis performance on an 鈥渆ndotrainer鈥? The program consisted of 4 weeks per year (20 h per week) between 2004 and 2007. The outcome measures were the time and number of anastomosis necessary to perform a proper anastomosis. Upon completion, the anastomosis was checked by both trainee and evaluator and quality was assessed. Time and technical failures (loose suture, edge eversion, leakage) were recorded.
Results
Twelve surgical residents were trained. They performed 189 jejuno-jejunal anastomoses (JJA), mean 15.8 per resident and 197 gastro-jejunal anastomoses (GJA), mean 16.4 per resident. The performance mean time was 72.7 min for JJA and 87.2 for GJA. There was a marked reduction in time from the beginning to completion of training. The percentage of flawed anastomosis decreased with training: 26.6%, 21.8%, 17.1%, 17%, 16.1%and 10.5%after 20, 40, 60, 80, 100 and 120 h, respectively. Bearing in mind reduction in both performance time and flawed anastomosis rate, it appears that after 70 h of training the learning curve reaches a plateau zone.
Conclusions
Intestinal anastomosis (either JJA or GJA) performed in 鈥渆ndotrainer鈥?is a suitable model for laparoscopic training, without the need of live animals. After a training period of 70 hours, the improvement seems of little benefit.