Impact of a Simulated Laparoscopic Training Program in a Three-Year General Surgery Residency

Abstract

Background: A General Surgery Residency may last between 2-6 years, depending on the country. A shorter General Surgery Residency must optimize residents’ surgical exposure. Simulated surgical training is known to shorten the learning curves, but information related to how it affects a General Surgery Residency regarding clinical exposure is scarce. Aim: To analyze the effect of introducing a validated laparoscopic simulated training program in abdominal procedures performed by residents in a three-year General Surgery Residency program. Methods: A non-concurrent cohort study was designed. Four-generations (2012-2015) of graduated surgeons were included. Only abdominal procedures in which the graduated surgeons were the primary surgeon were described and analyzed. The control group was of graduated surgeons from 2012 without the laparoscopic simulated training program. Surgical procedures per program year, surgical technique, emergency/elective intervention and hospital-site (main/community hospitals) were described. Results: Interventions of 28 graduated surgeons were analyzed (control group=5; laparoscopic simulated training program=23). Graduated surgeons performed a mean of 372 abdominal procedures, with a higher mean number of medium-to-complex procedures in laparoscopic simulated training program group (48 vs. 30, p=0.02). Graduated surgeons trained with laparoscopic simulated training program performed a higher number of total abdominal procedures (384 vs. 319, p=0.04) and laparoscopic procedures (183 vs. 148, p<0.05). Conclusions: The introduction of laparoscopic simulated training program may increase the number and complexity of total and laparoscopic procedures in a three-year General Surgery Residency.

Lessons learned during the COVID-19 pandemic using virtual basic laparoscopic training in Santa Cruz de la Sierra, Bolivia: effects on confidence, knowledge, and skill

“…Initial courses were met with much enthusiasm and demonstrated improvements in confidence and skill for basic laparoscopic skills [ 8 ]. These efforts met with successes similar to those described by others globally who have implemented laparoscopic training programs in countries including Argentina [ 9 ], Chile [ 10 ], Mongolia [ 11 ], Kenya [ 12 ], and Tanzania [ 13 ].…”

“…This program has been implemented in both Mexico [ 22 ] and Costa Rica [ 23 ], where participants have shown increased confidence in their ability to perform laparoscopic cholecystectomies safely. In Chile, a basic skills program is combined with virtual reality modules with ex vivo tissue model simulation to create a more advanced laparoscopic skill program that has resulted in greater exposure to laparoscopic surgery during training [ 10 ]. Tele-mentoring via a mobile application called “Lapp” has also successfully improved laparoscopic hand-sewn jejunojejunostomy performance among Chilean surgical trainees [ 16 ].…”

Ten years of IRCAD, Barretos, SP, Brazil

“…It also provides several benefits, including a low-risk environment, valuable improvement in patient safety, and optimization of endoscopy time 34 . Tejos et al 35 demonstrated that surgeons trained in a virtual simulator develop greater skills in the execution of knots within a shorter period of time.…”

Entrenamiento en suturas para profesionales de la salud: experiencia inicial de un curso de formación continua

“…Clásicamente, estos profesionales aprenden a suturar siendo alumnos durante la práctica directa con pacientes, bajo el modelo tradicional de enseñanza médica de Halsted: "mira uno, realiza uno, enseña uno". 1 Una de las principales limitaciones de este modelo se observa en la enseñanza de procedimientos, debido a una falta de estandarización. 2 Entre los factores que influyen en esto se advierte la desigual exposición clínica, la escasa disponibilidad de horario de docentes clínicos, la necesidad de instrumental especializado, la limitación de espacio físico y las características personales de docentes y alumnos.…”