′Stepped procedure ′ in laparoscopic cyst decortication during the learning period of laparoscopic surgery: Detailed evaluation of initial experiences

Abstract

BACKGROUND:We evaluated the importance and efficacy of 'stepped procedure' in laparoscopic cyst decortication as an initial experience in it.MATERIALS AND METHODS:A 36 renal cyst cases were included. The stepped retroperitonoscopic cyst excision divided into three groups. First step, doing the incisions to place the ports and expanding the retroperitoneal space with balloon distension, second step, placement of trocars and reach to the cyst, third step, aspiration and decortication of the cyst. The difficulty of the sessions was measured with the Visual Analog Scale (VAS) scoring system. Score was determined according to the difficulty of the surgical step ranging from '0' to '10', '0', too easy, '10' too difficult'. The durations were measured. One-way ANOVA test was used for statistical analysis.RESULTS:The mean age was 52.0 (20-75) years. The mean operation time was 52.0 min. The mean duration of the first step was 12.5, second, 26.0 and third, 22.5 min. The mean VAS of first step, 3.2, second, 6.0 and third, 3.6 There were only significant differences in duration time and VAS score for second step among the surgeons (P<0.05).CONCLUSIONS:Laparoscopic cyst decortication may provide gaining experience to approach the kidney laparoscopically. The side, size and localization of cysts were not found associated with the difficulty of the method.

Comparison and Description of Transdiaphragmatic and Abdominal Minimally Invasive Cisterna Chyli Ablation in Dogs

“…The VAS was used as it allows the measurement of values that cannot be measured directly, is simple to use, and provides a means by which to quantify data over a continuum. This scoring system was not validated within the context of this study, but VAS scoring has been used to score procedure difficulty in human laparoscopic surgery and other procedure skills . Additionally, whereas we did not include statistical information about the first 2 dogs in each technique series, we did not document a declining slope of a learning curve before comparing procedures.…”

Impact of cadaveric surgical anatomy training on urology residents knowledge: a preliminary study

“…During the learning period, using the surgical steps to determine the lack of training could be suggested. [22] Nonetheless, whether this course will impact on surgical training remains to be proven.…”