Expertise and Skill in Minimally Invasive Surgery

Abstract

New attitudes to medical ethics and demands for efficiency have brought increased attention to surgical skills and training. It is important to characterize the expertise and skill involved in the multidimensional surgical profession. At a time of change, there is a need to discuss the nature of surgical expertise, and also the prospects for resident training, with special reference to new minimally invasive techniques (MIS). In this paper, we selectively review knowledge on surgical expertise and the specific demands placed on a skilled MIS surgeon. In addition, the review contains a selection of studies from those areas that have been seen as important for the future of training in surgery.

Video-assisted surgery: suggestions for failure prevention in laparoscopic cholecystectomy

“…For example, consideration should be made in terms of the parts of training that should be realized outside operating theatres and which parts are essential to conduct in authentic situations (Silvennoinen et al 2009). In fact, learning professionalism (tacit knowledge) in surgery, such as attitudes, values, and behaviors, good role models in the form of specialist instructors are an important force influencing residents' professional development (Park et al 2010).…”

“…Since the introduction of LC almost 20 years ago, the complication rates have remained basically the same and bile duct injury is still a serious risk in this procedure (Nuzzo et al 2008;Ponsky 1991). This procedure takes a relatively long period to learn, as the surgical trainee proceeds under supervision, gradually with increasing responsibility towards becoming an independently operating specialist expert surgeon (Ericsson 2004;Patel et al 2001;Silvennoinen et al 2009). Various methods for LC technical skill training for surgical residents have been implemented to aid this learning process such as box trainers and virtual reality simulators (Aggarwal et al 2009;Ikonen et al 2012).…”

Technology-enhanced surgical education: attitudes and perceptions of the endoscopic surgery community in Turkey

“…During surgery, they need to make quick and accurate decisions and operate in an environment in which they are in constant interaction with the assistants and nurses. In this way, teamwork becomes a required trait as well 4. Traditional surgery education is provided in the operating theatre with the supervision of an experienced surgeon using the ‘see one-do one-teach one’ method 5 6.…”

Is Learning in Low Immersive Environments Carried over to High Immersive Environments?

“…Many studies, oriented at laparoscopic surgery research, employed virtual reality techniques [14,[16][17][18][19][20]. Most of these studies were explicitly occupied with the effect of visual display dimensionality (2D versus 3D) and visual display location on the operator (surgeon) performance [18][19][20] or task difficulty [16,17].…”

“…Most of these studies were explicitly occupied with the effect of visual display dimensionality (2D versus 3D) and visual display location on the operator (surgeon) performance [18][19][20] or task difficulty [16,17]. In one survey, expert surgeons indicated depth perception as an important technological challenge for improving laparoscopy systems although opinion is not conclusive regarding the importance of 3D display [17].…”