Effects of Surgical Simulation on the Implementation of Laparoscopic Colorectal Procedures

Palazuelos, Carlos Manuel; Martín, J.A. Portillo; Parra, José Ignacio Martín; Ruiz, Marcos Gómez; Maestre, José María Maestre; Figuero, Carlos Redondo; Diego, Julio Castillo; Fleitas, Manuel Gómez

doi:10.1016/j.cireng.2013.03.003

Cited by 6 publications

(2 citation statements)

References 13 publications

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“…Surgical simulators have been developed and validated in a number of surgical disciplines including general surgery , endovascular surgery , orthopaedic surgery and urology . Amongst the urological sub‐specialties, simulators developed for procedures relating to the kidney and ureters demonstrate the highest levels of available and validated surgical simulators .…”

Section: Discussionmentioning

confidence: 99%

Simulation‐based training for prostate surgery

et al. 2015

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A review of the literature between 1999 and 2014 was performed. The search terms included a combination of urology, prostate surgery, robotic prostatectomy, laparoscopic prostatectomy, transurethral resection of the prostate (TURP), simulation, virtual reality, animal model, human cadavers, training, assessment, technical skills, validation and learning curves. Furthermore, relevant abstracts from the American Urological Association, European Association of Urology, British Association of Urological Surgeons and World Congress of Endourology meetings, between 1999 and 2013, were included. Only studies related to prostate surgery simulators were included; studies regarding other urological simulators were excluded. ResultsA total of 22 studies that carried out a validation study were identified. Five validated models and/or simulators were identified for TURP, one for photoselective vaporisation of the prostate, two for holmium enucleation of the prostate, three for laparoscopic radical prostatectomy (LRP) and four for robotassisted surgery. Of the TURP simulators, all five have demonstrated content validity, three face validity and four construct validity. The GreenLight laser simulator has demonstrated face, content and construct validities. The Kansai HoLEP Simulator has demonstrated face and content validity whilst the UroSim HoLEP Simulator has demonstrated face, content and construct validity. All three animal models for LRP have been shown to have construct validity whilst the chicken skin model was also content valid. Only two robotic simulators were identified with relevance to robot-assisted laparoscopic prostatectomy, both of which demonstrated construct validity. ConclusionsA wide range of different simulators are available for prostate surgery, including synthetic bench models, virtual-reality platforms, animal models, human cadavers, distributed simulation and advanced training programmes and modules. The currently validated simulators can be used by healthcare organisations to provide supplementary training sessions for trainee surgeons. Further research should be conducted to validate simulated environments, to determine which simulators have greater efficacy than others and to assess the cost-effectiveness of the simulators and the transferability of skills learnt. With surgeons investigating new possibilities for easily reproducible and valid methods of training, simulation offers great scope for implementation alongside traditional methods of training.

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Section: Discussionmentioning

confidence: 99%

Simulation‐based training for prostate surgery

et al. 2015

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“…We complement this opinion with the fact that financial constraints decelerated the spread of modern laparoscopic colorectal procedures in Hungary before 2014 [ 18 ]. If the increasing efficiency were aimed at, it would be useful to utilize the positive effect of a standardized surgical technique, training courses and surgical simulation on the implementation of laparoscopic colorectal procedures [ 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Potential considerations in decision making on laparoscopic colorectal resections in Hungary based on administrative data

2021

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Background Laparoscopic colorectal surgeries offer numerous advantages over their open counterparts. To compare these measurable short-time outcomes of open and laparoscopic resections in Hungary, data of colorectal surgeries were collected and analysed. The study focused on identifying patients’ characteristics that can influence the decision on laparoscopic colorectal resections and on comparing efficiency of Hungarian colorectal operations with international data. Methods Using patients’ data of laparoscopic and open colorectal surgery performed in 2015 and 2016 from the National Health Insurance Fund of Hungary, a countrywide retrospective comparative analysis was done. Logistic regression was used to explore main influencing factors for laparoscopic colorectal surgery. Results A total of 17,876 colorectal surgical cases, including 14,876 open and 3,000 laparoscopic resections were selected and analysed. Laparoscopy was used only in 16.78% of all cases. Comparison of age groups showed that odds ratio (OR) of laparoscopic colorectal resections was significantly lower in over 40 years than in younger patients (18–39 years). In university institutes patients had higher odds (OR: 2.23 p<0.0001) for laparoscopic colorectal resections. Presence of comorbidity codes and preoperative treatment in internal medicine department decreased odds for laparoscopic colorectal operations. Conclusions Patients’ age, comorbidities and hospital type influenced the likelihood of decision on laparoscopic colorectal resection. Selection of patients contributed to improved laparoscopic outcomes.

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