Minimally Invasive Surgical Training Solutions for the Twenty-First Century

Rosser, James C.; Murayama, Michinori; Gabriel, Nick H.

doi:10.1016/s0039-6109(05)70248-6

Cited by 54 publications

(32 citation statements)

References 11 publications

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“…Besides knowledge of the disease, therapeutic alternatives, indications for surgery and the options of the surgical approach, these advanced procedures require a much higher level of competence in order to be completed successfully [17] . The competence required is much more than the technical surgical abilities necessary for a laparoscopic procedure.…”

Section: Discussionmentioning

confidence: 99%

Teach the Teachers: An Observational Study on Mentor Traineeship in Gynecological Laparoscopic Surgery

Kolkman

Engels²,

Smeets³

et al. 2006

Gynecol Obstet Invest

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Background: To evaluate the effect of a mentor traineeship in laparoscopic surgery in a teaching hospital. Method: This observational study was performed between January 1997 and December 2004 at Bronovo Hospital, The Hague, The Netherlands. Since January 2001, an advanced endoscopic gynecologist has mentored a trainee in laparoscopic surgery. Data on the trainee’s procedures preceding (1997–2000) and during the mentor traineeship (2001–2004) were compared. The number and type of procedures performed, complications and conversions were derived from a prospectively kept database supplemented by a retrospective chart review. Operating times for total laparoscopic hysterectomy (TLH) were registered to establish the trainee’s learning curve. Results: Since the presence of a mentor, the trainee has performed significantly more advanced laparoscopic procedures. Despite the significant increase in advanced cases, the trainee’s laparoscopic conversion rate to laparotomy remained stable between period 1 and period 2 (7.5 and 4.5%, respectively, p = 0.35, 95% CI –0.033 to 0.092); moreover, for level-3 procedures the conversion rate decreased (p < 0.001, 95% CI 0.30–0.71). Despite the increase in advanced cases, the total complication rate remained stable (3.2–4.5%, p = 0.62, 95% CI –0.07 to 0.04) including the number of level-3 complications (p = 0.63, 95% CI –0.4 to 0.3). A decreasing trend in operating time for TLH was found; however, this was not significant (Spearman correlation coefficient –0.421, p = 0.81). Conclusions: Mentor traineeship in gynecology enhanced the advanced laparoscopic caseload. With the increase in advanced procedures, no increase in conversion rate, complication rate or operating times for TLH was found. Due to the mentorship, patients were not exposed to increased complications and conversions, or to the disadvantages of a prolonged operating time. Predominantly, mentor traineeship facilitated the implementation of laparoscopic surgery into an established gynecological practice in a teaching hospital.

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Section: Discussionmentioning

confidence: 99%

Teach the Teachers: An Observational Study on Mentor Traineeship in Gynecological Laparoscopic Surgery

Kolkman

Engels²,

Smeets³

et al. 2006

Gynecol Obstet Invest

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“…Telementoring permits an expert surgeon, who remains in his/her own hospital, to instruct a novice in a remote location on how to perform a new operation or use a new surgical technology. Telepresence thus provides a new strategy for the training of surgical residents [10,11] as well as a new means of disseminating novel surgical approaches around the world [12].…”

Section: Telementoringmentioning

confidence: 99%

Robotic surgery, telerobotic surgery, telepresence, and telementoring

2002

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Although laparoscopic cholecystectomy rapidly became the standard of care for the surgical treatment of cholelithiasis, very few other abdominal or cardiac operations are currently performed using minimally invasive surgical techniques. The inherent limitations of traditional laparoscopic surgery make it difficult to perform these operations. We, and others, have attempted to use robotic technology to (a) provide a stable camera platform, (b) replace two-dimensional with three-dimensional (3-D) imaging, (c) simulate the fluid motions of a surgeon's wrist to overcome the motion limitations of straight laparoscopic instruments, and (d) offer the surgeon a comfortable, ergonomically optimal operating position. In this article, we review the early published clinical experience with surgical robotic and telerobotic systems and assess their current limitations. The voice-controlled AESOP robot replaces the cameraperson and facilitates the performance of solo-surgeon laparoscopic operations. AESOP provides a stable camera platform and avoids motion sickness in the operative team. The telerobotic Zeus and da Vinci surgical systems permit solo surgery by a surgeon from a remote sight. These telerobots hold the camera, replace the surgeon's two hands with robotic instruments, and serve in a master-slave relationship for the surgeon. Their robotic instruments simulate the motions of the surgeon's wrist, facilitating dissection. Both telerobots use 3-D imaging to immerse the surgeon in a three-dimensional video operating field. These robots also provide operating positions for the surgeon console that are ergonomically superior to those required by traditional laparoscopy. The technological advances of these telerobots now permit telepresence surgery from remote locations, even locations thousands of miles away. In addition, telepresence permits the telementoring of novice surgeons who are performing new procedures by expert surgeons in remote locations. The studies reviewed here indicate that robotics and telerobotics offer potential solutions to the inherent problems of traditional laparoscopic surgery, as well as new possibilities for telesurgery and telementoring. Nonetheless, these technologies are still in an early stage of development, and each device entails its own set of challenges and limitations for actual use in clinical settings.

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“…These skills can generally be classified into cognitive (acquisition of the necessary theoretical knowledge), motor (mastering of the surgical gestures and processes), and judgment skills (knowing what to do and how to react when faced with different scenarios) [5,6]. Cognitive knowledge can be obtained by different means, such as seminars and courses, or by employing multimedia didactic material in the form of books, CD-ROMs [7], and especially endoscopic videos, which are one of the most important sources of information available in this field [8].…”

Section: Introductionmentioning

confidence: 99%

TELMA: Technology-enhanced learning environment for minimally invasive surgery

Sánchez-González

Burgos

García

et al. 2013

Journal of Surgical Research

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Background: Cognitive skills training for minimally invasive surgery has traditionally relied upon diverse tools, such as seminars or lectures. Web technologies for e-learning have been adopted to provide ubiquitous training and serve as structured repositories for the vast amount of laparoscopic video sources available. However, these technologies fail to offer such features as formative and summative evaluation, guided learning, or collaborative interaction between users.

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Minimally Invasive Surgical Training Solutions for the Twenty-First Century

Cited by 54 publications

References 11 publications

Teach the Teachers: An Observational Study on Mentor Traineeship in Gynecological Laparoscopic Surgery

Teach the Teachers: An Observational Study on Mentor Traineeship in Gynecological Laparoscopic Surgery

Robotic surgery, telerobotic surgery, telepresence, and telementoring

TELMA: Technology-enhanced learning environment for minimally invasive surgery

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