Surgical teaching does not increase the risk of intraoperative adverse events

Pache, Basile; Grass, Fabian; Fournier, Nicolas; Demartines, Nicolas; Hahnloser, Dieter

doi:10.1007/s00384-018-3143-2

Cited by 6 publications

(4 citation statements)

References 38 publications

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“…First, advanced expertise in robotic surgery allowed for safe surgery despite unfavorable and challenging conditions with complicated disease. Second, standardized approach and teaching conditions lead to better outcomes, as repeatedly shown previously [27][28][29]. Finally and most importantly, high compliance to the institutional ERP, yielding over 70% even in patients with complicated disease, may have significantly contributed to these encouraging results.…”

Section: Discussionmentioning

confidence: 71%

Feasibility and safety of robotic resection of complicated diverticular disease

et al. 2019

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This study aimed to assess intra-and postoperative outcomes of robotic resection of left-sided complicated diverticular disease. Retrospective analysis of a prospectively maintained institutional database on consecutive patients undergoing elective robotic resection for diverticular disease (2014)(2015)(2016)(2017)(2018). All procedures were performed within an enhanced recovery pathway (ERP). Demographic, surgical and ERP-related items were compared between patients with simple and complicated diverticular disease according to intra-operative presentation. Postoperative complications and length of stay were compared between the two groups. Out of 150 patients, 78 (52%) presented with complicated and the remaining 72 (48%) with uncomplicated disease. Both groups were comparable regarding demographic baseline characteristics and overall ERP compliance. Surgery for complicated disease was longer (288 ± 96 vs. 258 ± 72 min, p = 0.04) and more contaminated (≥ class 3: 57.7 vs. 23.6%, p < 0.001) with a trend to higher conversion rates (10.3 vs. 2.8%, p = 0.1). While postoperative overall complications tended to occur more often after resections for complicated disease (28.2 vs. 15.3%, p = 0.075), major, surgical and medical complications did not differ between the two groups, and median length of stay was 3 days in both settings (p = 0.19). Robotic resection of diverticular disease was feasible and safe regardless of disease presentation by the time of surgery.

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Section: Discussionmentioning

confidence: 71%

Feasibility and safety of robotic resection of complicated diverticular disease

et al. 2019

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“…24,25 In studies involving colorectal resections, trainees performing surgery with the consultant mentors assisting have been shown to yield non-inferior outcomes when compared to consultants performing the surgery themselves. [26][27][28][29] A survey of surgeon mentors also found that the ASU allowed more time for education and was beneficial for surgical training of juniors. 30 Several other studies also found that increased consultant presence increased registrar case load and satisfaction.…”

Section: Egs Should Be Consultant Ledmentioning

confidence: 99%

“…The involvement of consultant surgeons in emergency surgeries has resulted in decreased complication rates . In studies involving colorectal resections, trainees performing surgery with the consultant mentors assisting have been shown to yield non‐inferior outcomes when compared to consultants performing the surgery themselves …”

Section: Review Of Gsa 12‐point Planmentioning

confidence: 99%

General Surgeons Australia's 12‐point plan for emergency general surgery

Ang

Wong

Truskett

2019

ANZ Journal of Surgery

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In the last decade, emergency general surgery (EGS) in Australia and New Zealand has seen a transition from the traditional on‐call system to the acute surgical unit (ASU) model. The importance and growing demand for EGS has resulted in the implementation of the General Surgeons Australia's 12‐point plan for emergency surgery. Since its release, the 12‐point plan has been used as a benchmark of a well‐functioning ASU, both locally and abroad. This study aims to provide a descriptive review on the relevance of the 12‐point plan to the ASU model and review the current evidence to support this framework. The review concludes that the establishment of the ASU model has met the aims set out by the Royal Australasian College of Surgeons for EGS. The 12‐point plan is relevant and has good evidence to support its framework.

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“…With regard to laparoscopic colorectal surgery, it has been shown that residents during their final years very well can achieve results that do not affect patient safety and short-term outcome adversely [58]. And some authors did not find any difference in intraoperative adverse effects during colonic procedures when comparing consultants with trainees [59].…”

Section: Literature Regarding Training In Gep-netmentioning

confidence: 99%

Training in endocrine surgery

Gimm

Barczyński

Mihai

et al. 2019

Langenbecks Arch Surg

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Background/purpose In Europe, the Division of Endocrine Surgery (DES) determines the number of operations (thyroid, neck dissection, parathyroids, adrenals, neuroendocrine tumors of the gastro-entero-pancreatic tract (GEP-NETs)) to be required for the European Board of Surgery Qualification in (neck) endocrine surgery. However, it is the national surgical boards that determine how surgical training is delivered in their respective countries. There is a lack of knowledge on the current situation concerning the training of surgical residents and fellows with regard to (neck) endocrine surgery in Europe. Methods A survey was sent out to all 28 current national delegates of the DES. One questionnaire was addressing the training of surgical residents while the other was addressing the training of fellows in endocrine surgery. Particular focus was put on the numbers of operations considered appropriate. Results For most of the operations, the overall number as defined by national surgical boards matched quite well the views of the national delegates even though differences exist between countries. In addition, the current numbers required for the EBSQ exam are well within this range for thyroid and parathyroid procedures but below for neck dissections as well as operations on the adrenals and GEP-NETs.Conclusions Training in endocrine surgery should be performed in units that perform a minimum of 100 thyroid, 50 parathyroid, 15 adrenal, and/or 10 GEP-NET operations yearly. Fellows should be expected to have been the performing surgeon of a minimum of 50 thyroid operations, 10 (central or lateral) lymph node dissections, 15 parathyroid, 5 adrenal, and 5 GEP-NET operations.

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Surgical teaching does not increase the risk of intraoperative adverse events

Abstract: Within a standardized teaching environment, colonic resections were safely performed regardless of the surgical setting in the present cohort. Teaching does not increase intraoperative adverse events.

Cited by 6 publications

References 38 publications

Feasibility and safety of robotic resection of complicated diverticular disease

Feasibility and safety of robotic resection of complicated diverticular disease

General Surgeons Australia's 12‐point plan for emergency general surgery

Training in endocrine surgery

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