LPA seems to be safe with equivalent oncological outcomes to OPA and better short term outcomes in selected patient populations. High quality Randomized control trials are required to further investigate the role of laparoscopy in transverse colon cancer.

BackgroundChanges in UK legislation allow for surgical procedures to be performed on cadavers. The aim of this study was to assess Thiel cadavers as high-fidelity simulators and to examine their suitability for surgical training.MethodsSurgeons from various specialties were invited to attend a 1 day dissection workshop using Thiel cadavers. The surgeons completed a baseline questionnaire on cadaveric simulation. At the end of the workshop, they completed a similar questionnaire based on their experience with Thiel cadavers. Comparing the answers in the pre- and post-workshop questionnaires assessed whether using Thiel cadavers had changed the surgeons’ opinions of cadaveric simulation.ResultsAccording to the 27 participants, simulation is important for surgical training and a full-procedure model is beneficial for all levels of training. Currently, there is dissatisfaction with existing models and a need for high-fidelity alternatives. After the workshop, surgeons concluded that Thiel cadavers are suitable for surgical simulation (p = 0.015). Thiel were found to be realistic (p < 0.001) to have reduced odour (p = 0.002) and be more cost-effective (p = 0.003). Ethical constraints were considered to be small.ConclusionThiel cadavers are suitable for training in most surgical specialties.

The unparalleled epidemic of the novel coronavirus (COVID-19), during early December 2019 in Wuhan, China, has rapidly evolved into a global pandemic, became a matter of grave concern. The pandemic presented a unique challenge to government agencies worldwide. The paucity of resources and lack of knowledges to manage the pandemic, coupled with the fear of future consequences has established the need for adoption of emerging and future technologies to address the upcoming challenges. With introduction of measures to control the pandemic, trainees will see a dramatic decline in their in-person exposure to all aspects of their education, with no clear endpoint. This presents an extreme challenge for educators and, given the rapidly evolving situation, there have not yet been training authorities recommendations. We propose several innovative solutions to deliver medical education while maintaining the safety of residents and educators.

Background Traditional surgical training, largely based on the Halstedian model Bsee one, do one, teach one^is not as effective in the era of working time restrictions and elaborate shiftpatterns. As a result, contemporary surgeons turned to educational methods outside the operating theatre such as simulation. Cadavers are high fidelity models but their use has ethical and cost implications and their availability may be limited. In this review, we explore the role of cadaveric simulation in modern surgical education. Methods All the Evidence-Based Medicine databases were searched for relevant reviews. The resulting studies were assessed for inclusion to this review, according to predetermined criteria. Data extraction was performed using a custom-made spreadsheet, and the quality of included reviews was assessed using a validated scoring system (AMSTAR). Results The literature review yielded 33 systematic reviews; five of which matched the inclusion criteria and were included in this review of reviews. Cadaveric simulation was found to have good face (subjective assessment of usefulness) and content validity (whether a specific element adds or retracts to the educational value) while trainees improved their surgical skills after practicing on cadavers. However, concerns have been raised about ethical issues, high cost and availability. Conclusion Cadavers are an effective medium for surgical teaching, and it may be appropriate for them to be used whenever surrounding conditions such cost and availability allow. Further research is required to provide evidence on whether there is equivalence between cadavers and other educational media which may not bear the same shortcomings.

Background: Practice on Virtual Reality simulators (VRS) have been shown to improve surgical performance. However, VRS are expensive and usually housed in surgical skills centres that may be inaccessible at times convenient for surgical trainees to practice. Conversely, box trainers are inexpensive and can be used anywhere at anytime. This study assesses "take-home" Box Trainers (BT) as an alternative to VRS.Methods: After baseline assessments (two simulated laparoscopic cholecystectomies, one on a VRS and one on a BT) 25 surgical trainees were randomised to two groups. Trainees were asked to practice 3 basic laparoscopic tasks for 6 weeks (BT group using a "take-home" box trainer; VR group using VRS in clinical skills centres). After the practice period all performed two LC, one on a VRS and one on a BT; (i.e. post-training assessment). VRS provided metrics (total time (TT), number of movements (NOM) instrument tip path length (PL)) and expert video assessment of cholecystectomy in a BT (GOALS score) were recorded. Performance during pre-and post-training assessment was compared.Results: The BT group showed a significant improvement for all VRS metrics (p=0.008) and the efficiency category of GOALS score (p=0.03). Only TT improved in the VRS group and none of the GOALS categories demonstrated a statistically significant improvement after training.

There is a very limited amount of evidence to support that the use of video games enhances surgical simulation performance.

Study Design Single-blinded study. Objective To assess the suitability of three types of cadaver for simulating pedicle screw insertion and establish if there is an ideal. Methods Three types of cadaver—Thiel-embalmed, Crosado-embalmed, and formaldehyde-embalmed—were draped and the spines exposed. Experienced surgeons were asked to place pedicle screws in each cadaver and give written questionnaire feedback using a modified Likert scale. Soft tissue and bony properties were assessed, along with the role of simulation in spinal surgery training. Results The Thiel cadaver rated highest for soft tissue feel and appearance with a median score of 6 for both (range 2 to 7). The Crosado cadaver rated highest for bony feel, with a median score of 6 (range 2 to 7). The formaldehyde cadaver rated lowest for all categories with median scores of 2, 2.5, and 3.5, respectively. All surgeons felt pedicle screw insertion should be learned in a simulated setting using human cadavers. Conclusion Thiel and Crosado cadavers both offered lifelike simulation of pedicle screw insertion, with each having advantages depending on whether the focus is on soft tissue approach or technical aspects of bony screw insertion. Both cadaver types offer the advantage of long life span, unlike fresh frozen tissue, which means cadavers can be used multiple times, thus reducing the costs.

Background and Aims An online teaching programme for Core Surgical Trainees (CSTs) was designed and delivered during the COVID-19 pandemic. The aim of this study is to assess the feasibility and the reception of a fully online teaching programme. Methods Twenty teaching sessions were delivered either via Zoom™ or were pre-recorded and uploaded onto a Google Classroom™ and YouTube™ website. Online feedback, delivered via Google Forms™, were completed by CSTs following each teaching session. YouTube Studio™ analytics were used to understand patterns in viewing content. Results 89.9% of trainees were satisfied with the teaching series. Trainees preferred short, weekly sessions (79%), delivered by senior surgeons, in the form of both didactical and interactive teaching. YouTube analytics revealed that the highest peak in views was documented on the weekend before the deadline for evidence upload on the Intercollegiate Surgical Collegiate Programme (ISCP) portfolio. Conclusion An entirely online teaching programme is feasible and well-received by CSTs. Trainees preferred live, interactive, procedure-based, consultant-led sessions lasting approximately thirty minutes to one hour and covering a myriad of surgical specialties. This feedback can be used to improve future online surgical teaching regionally and nationally in order to gain training opportunities lost during the pandemic.