Model for simulated training of laparoscopic gastroenterostomy

Abstract

Purpose: To develop a model of gastroenterostomy and to analyze the acquisition of skills after training by simulation. Methods: Experimental longitudinal study and of a quantitative character. The sample consisted of twelve general surgery residents from four hospitals. The training consisted of making ten anastomoses divided equally into five sessions and it took place over a period of six weeks. The evaluation of the anastomoses considered the time and the analysis of the operative technique through the global evaluation scale Objective Structured Assessment of Technical Skills (OSATS). Results: Residents showed a reduction in operative time and evolution in the surgical technique statistically significant (p<0.01). The correlation index of 0.545 and 0.497 showed a high linear correlation between time variables and OSATS. Conclusion: The preparation of ten gastroenterostomies is an exercise capable of transferring basic and advanced skills in laparoscopy through a standardized training using synthetic organs and a simulator.

Evaluation tool for a gastroenterostomy simulated training

“…The evolution of the surgical technique and the final quality of the anastomosis was important, resulting in the last operation an average score of 33.4 points on the OSATS scale. There is a high linear correlation between the improvement in the OSATS scale score and the number of anastomoses made 9 .…”

“…The organs used during training with the residents were a stomach and a segment of synthetic jejunum. The gastroenterostomy was carried out through a continuous suture in single plane with two Seda 3.0 wires 9 .…”

Modelo para treinamento simulado de anastomoses cirúrgicas por laparoscopia

“…10 O programa de treinamento em cirurgia minimamente invasiva proporciona um elevado grau de satisfação aos seus participantes, e os capacita a realizar procedimentos técnicos mais complexos, como as suturas, além de melhorar seu 11 Um treinamento de anastomoses em órgãos sintéticos realizado com doze residentes de cirurgia geral mostrou que após a confecção de dez anastomoses, divididas em cinco sessões em um período de seis semanas, foi possível adquirir habilidades básicas e avançadas em cirurgia laparoscópica. 12 Segundo Cristancho, Moussa e Dubrowski, 13 a simulação treinamento levando em consideração os recursos disponíveis, utilizar ferramentas de avaliação de desempenho e realizar educacional proposto.…”

Simulated training of a laparoscopic vesicourethral anastomosis

“…Due to the scarcity of corpses and ethical and moral questions around their use, resources should not be directed to this model of simulation 13 . Therefore, the training of anastomoses in synthetic organs accommodated within black box simulators appears as an excellent option in continuing education in advanced laparoscopic surgery 14 .…”