Evolution of laparoscopic education and the laparoscopic learning curve: a review of the literature

Brian, Riley; Davis, Greta; Park, Keon Min

doi:10.21037/ls-22-29

Cited by 8 publications

(6 citation statements)

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“…It is reported that the learning curve for laparoscopic surgeries is steep, in contrast with the simpler linear curve of the open techniques [94,95]. Moreover, according to recent European guidelines, training in laparoscopic liver surgeries should follow a stepwise progression from open to laparoscopic and then robotic surgical techniques, which due to the limited number and specialized nature of these procedures, training in MIS should be part of fellowship programs [96,97]. Another point of consideration is that up to today, very few liver transplant centers apply MIS techniques in everyday clinical practice, limiting training possibilities.…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Surgery in Liver Transplantation: From Living Liver Donation to Graft Implantation

Avramidou,

Terlemes,

Lymperopoulou

et al. 2024

Livers

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Since the end of the 20th century and the establishment of minimally invasive techniques, they have become the preferred operative method by many surgeons. These techniques were applied to liver surgery for the first time in 1991, while as far as transplantation is concerned their application was limited to the living donor procedure. We performed a review of the literature by searching in Pubmed and Scopus using the following keywords: Liver transplantation, Minimally invasive surgery(MIS) living liver donor surgery. Applications of MIS are recorded in surgeries involving the donor and the recipient. Regarding the recipient surgeries, the reports are limited to 25 patients, including combinations of laparoscopic, robotic and open techniques, while in the living donor surgery, the reports are much more numerous and with larger series of patients. Shorter hospitalization times and less blood loss are recorded, especially in centers with experience in a large number of cases. Regarding the living donor surgery, MIS follows the same principles as a conventional hepatectomy and is already the method of choice in many specialized centers. Regarding the recipient surgery, significant questions arise mainly concerning the safe handling of the liver graft.

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Section: Discussionmentioning

confidence: 99%

Minimally Invasive Surgery in Liver Transplantation: From Living Liver Donation to Graft Implantation

Avramidou,

Terlemes,

Lymperopoulou

et al. 2024

Livers

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“…Although different modalities have been used for laparoscopic simulated training over time (24), there are differences worth mentioning. While short and intensive formats (or "bootcamps") could be completed more quickly, they generally bring limited outcomes regarding scores, timing, and long-term retention of skills, and they take the trainee away from deliberate practice and the time required to consolidate new knowledge (25,26).…”

Section: Simulation In Surgerymentioning

confidence: 99%

Recommendations to develop a laparoscopic surgical simulation training program. Insights gained after 12 years of training surgeons

Duran-Espinoza,

Montero-Jaras,

Miguieles-Schilling

et al. 2022

MedUNAB

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Introduction. The use of simulation in surgery has made it possible to shorten learning curves through deliberate practice. Although it has been incorporated long ago, there are still no clear recommendations to standardize its development and implementation. This manuscript aims to share recommendations based on our experience of more than twelve years of employing and improving a methodology in laparoscopic surgical simulation. Topics for Reflection. To transfer surgical skills to a trainee, we base our methodology on a three-pillar framework: The hardware and infrastructure (tools to train with), the training program itself (what to do), and the feedback (how to improve). Implementing a cost-effective program is feasible: the hardware does not need to be high fidelity to transfer skills, but the program needs to be validated. These pillars have evolved over time by incorporating technology: the on-site guidance from experts has changed to a remote and asynchronous modality by video recording the trainee’s execution, and by enabling remote and asynchronous feedback. The feedback provider does not necessarily have to be an expert clinician in the subject, but a person previously trained to be a trainer. This allows for deliberate practice until mastery has been reached and learning curves are consolidated. Conclusions. Recommendations based on the experience of our center have been presented, explaining the framework of our strategy. Considering these suggestions, it is hoped that our simulation methodology can aid the development and implementation of effective simulation-based programs for other groups and institutions.

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“… 1 – 3 Unfortunately, acquiring the skills to perform laparoscopic surgery is challenging, and prior work has demonstrated that a significant proportion of senior surgical trainees struggle to perform laparoscopic procedures. 4 – 6 To address this problem, many educators have turned to laparoscopic simulation, which can improve trainee performance on simulated tasks and in the operating room. 7 – 10 In fact, prior work has suggested that laparoscopic simulation may enable trainees to outperform attending surgeons.…”

Section: Introductionmentioning

confidence: 99%

An At-Home Laparoscopic Curriculum for Junior Residents in Surgery, Obstetrics/Gynecology, and Urology

Brian,

Bayne,

Ito

et al. 2024

MedEdPORTAL

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Introduction Laparoscopic surgery requires significant training, and prior studies have shown that surgical residents lack key laparoscopic skills. Many educators have implemented simulation curricula to improve laparoscopic training. Given limited time for dedicated, in-person simulation center practice, at-home training has emerged as a possible mechanism by which to expand training and promote practice. There remains a gap in published at-home laparoscopic curricula employing embedded feedback mechanisms. Methods We developed a nine-task at-home laparoscopic curriculum and an end-of-curriculum assessment following Kern's six-step approach. We implemented the curriculum over 4 months with first- to third-year residents. Results Of 47 invited residents from general surgery, obstetrics/gynecology, and urology, 37 (79%) participated in the at-home curriculum, and 25 (53%) participated in the end-of-curriculum assessment. Residents who participated in the at-home curriculum completed a median of six of nine tasks (interquartile range: 3–8). Twenty-two residents (47%) responded to a postcurriculum survey. Of these, 19 (86%) reported that their laparoscopic skills improved through completion of the curriculum, and the same 19 (86%) felt that the curriculum should be continued for future residents. Residents who completed more at-home curriculum tasks scored higher on the end-of-curriculum assessment ( p = .009 with adjusted R 2 of .28) and performed assessment tasks in less time ( p = .004 with adjusted R 2 of .28). Discussion This learner-centered laparoscopic curriculum provides guiding examples, spaced practice, feedback, and graduated skill development to enable junior residents to improve their laparoscopic skills in a low-stakes, at-home environment.

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Evolution of laparoscopic education and the laparoscopic learning curve: a review of the literature

Cited by 8 publications

References 0 publications

Minimally Invasive Surgery in Liver Transplantation: From Living Liver Donation to Graft Implantation

Minimally Invasive Surgery in Liver Transplantation: From Living Liver Donation to Graft Implantation

Recommendations to develop a laparoscopic surgical simulation training program. Insights gained after 12 years of training surgeons

An At-Home Laparoscopic Curriculum for Junior Residents in Surgery, Obstetrics/Gynecology, and Urology

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