Training in endocrine surgery

Gimm, Oliver; Barczyński, Marcin; Mihai, Radu; Raffaelli, Marco

doi:10.1007/s00423-019-01828-4

Cited by 13 publications

(6 citation statements)

References 87 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, the present series emphasises the importance of adequate training and experience (i.e., annual case volume and cumulative experience) for surgeons dealing with thyroid surgery [10,18,19]. All the reported WSS cases would have been prevented if the primary surgery has been performed and/or supervised by an experienced endocrine/thyroid surgeon.…”

Section: Preventive Strategiesmentioning

confidence: 87%

Analysis and outcomes of wrong site thyroid surgery

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background In thyroid surgery, wrong-site surgery (WSS) is considered a rare event and seldom reported in the literature. Case presentation This report presents 5 WSS cases following thyroid surgery in a 20-year period. We stratified the subtypes of WSS in wrong target, wrong side, wrong procedure and wrong patient. Only planned and elective thyroid surgeries present WSS cases. The interventions were performed in low-volume hospitals, and subsequently, the patients were referred to our centres. Four cases of wrong-target procedures (thymectomies [n = 3] and lymph node excision [n = 1] performed instead of thyroidectomies) and one case of wrong-side procedure were observed in this study. Two wrong target cases resulting additionally in wrong procedure were noted. Wrong patient cases were not detected in the review. Patients experienced benign, malignant, or suspicious pathology and underwent traditional surgery (no endoscopic or robotic surgery). 40% of WSS led to legal action against the surgeon or a monetary settlement. Conclusion WSS is also observed in thyroid surgery. Considering that reports regarding the serious complications of WSS are not yet available, these complications should be discussed with the surgical community. Etiologic causes, outcomes, preventive strategies of WSS and expert opinion are presented.

show abstract

Section: Preventive Strategiesmentioning

confidence: 87%

Analysis and outcomes of wrong site thyroid surgery

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…Center influence on complications was not possible to assess given the large number of centers and the small number of patients from most centers. Generally, GEP-NEN surgery should be performed at centers with a high level of experience in abdominal endocrine surgery [34].…”

Section: Discussionmentioning

confidence: 99%

Complications of surgery for gastro-entero-pancreatic neuroendocrine neoplasias

Albers

Almquist

Bergenfelz

et al. 2020

Langenbecks Arch Surg

View full text Add to dashboard Cite

Purpose Surgery is recommended for most patients with gastro-entero-pancreatic neuroendocrine neoplasias (GEP-NENs). Rates of complications and perioperative mortality have been reported in few mostly retrospective single-center series, but there has been no detailed analysis on risk factors for perioperative complications and mortality to date. Methods Data of patients with GEP-NENs operated between January 2015 and September 2018 were retrieved from EUROCRINE©, a European online endocrine surgical quality registry, and analyzed regarding rate and risk factors of surgical complications. Risk factors were assessed by logistic regression. Results Some 376 patients (211 female, 167 male; age median 63, range 15-89 years) were included. Most NENs were located in the small intestine (SI) (n = 132) or pancreas (n = 111), the rest in the stomach (n = 34), duodenum (n = 30), appendix (n = 30), colon, and rectum (n = 22), or with unknown primary (n = 15). Of the tumors, 320 (85.1%) were well or moderately differentiated, and 147 (39.1%) of the patients had distant metastases at the time of operation. Severe complications (Dindo-Clavien ≥ 3) occurred in 56 (14.9%) patients, and 4 (1.1%) patients died perioperatively. Severe complications were more frequent in surgery for duodenopancreatic NENs (n = 31; 22.0%) compared with SI-NENs (n = 15; 11.4%) (p = 0.014), in patients with lymph node metastases operated with curative aim of surgery (n = 24; 21.4%) versus non-metastasized tumors or palliative surgery (n = 32; 12.1%) (p = 0.020), and in functioning tumors (n = 20; 23.0%) versus non-functioning tumors (n = 30; 13.5%) (p = 0.042). Complication rates were not significantly associated with tumor stage or grade. Conclusions Severe complications are frequent in GEP-NEN surgery. Besides duodenopancreatic tumor location, curative resection of nodal metastases and functioning tumors are risk factors for complications.

show abstract

“…However, this goal is not always achieved. A recent analysis of endocrine surgical training across 22 European countries demonstrated below-expected scores of performances for thyroid surgery and lateral neck dissection [ 1 ]. The expected median values for thyroidectomy and neck dissection were 10 and 2, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the literature demonstrates that competency in minimally invasive adrenal surgery is achieved at roughly, 30 procedures. While 20 and 15 procedures are required to attain proficiency in performing thyroid surgery and neck dissection, respectively [ 1 , 3 , 4 ]. In the context of these figures, the need emerges for novel resources that help achieve the purpose of any subspecializing training in surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Subspecialization in Endocrine Surgery, as in other surgical disciplines, aims to yield surgeons with an adequate level of proficiency and safety in performing various procedures independently and competently following a proper learning curve [1][2][3][4][5][6][7]. As performance tends to improve with experience, a trainee's volume or annual caseload becomes the cornerstone of any given surgical educational program [1,[3][4][5][6][7][8][9]. It has also been demonstrated that trainees considerably benefit from surgical simulation [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

SimLife model: introducing a new teaching device in endocrine surgery simulation

et al. 2020

View full text Add to dashboard Cite

To evaluate the validity and reliability of an innovative training model for endocrine surgical procedures. A simulator training model for endocrine procedures (SimLife) was developed at an academic center. The model consisted of a realistic operating environment with a coherent simulated patient dynamized by pulsatile vascularization with simulated blood warmed to 37 °C, and ventilation. Training sessions were designed for adrenal and thyroid surgery, as well as neck dissection. The primary outcome of interest was to evaluate learners’ performance and satisfaction. Learners’ performance was evaluated based on a scoring scale that followed the Downing method for the assessment of competency. While learners’ satisfaction was evaluated using a Likert scale of 1 to 10 on four items (ease of learning, anatomic correspondence of landmarks, realism, and overall satisfaction). Participants were engaged in 32 training sessions. These included 24 adrenalectomies (conventional and laparoscopic both transabdominal and posterior), and 4 thyroid lobectomies with concomitant functional lateral compartment neck dissection. competency scores were procedure-specific addressing specific core components of a given procedure. Learners’ performance scored above average in all procedures evaluated. Satisfaction scores for the specified four items ranged between 8.43 (SD 0.87) and 8.89 (SD 0.96). No major events were reported for the adrenalectomies, while only one jugular vein injury occurred during neck dissection. SimLife is a hyper-realistic training model that allows for satisfactory acquisition of skills and the evaluation of performance progression. It has the potential to become a cornerstone in specialized surgical training. Electronic supplementary material The online version of this article (10.1007/s13304-020-00871-x) contains supplementary material, which is available to authorized users.

show abstract

Training in endocrine surgery

Cited by 13 publications

References 87 publications

Analysis and outcomes of wrong site thyroid surgery

Analysis and outcomes of wrong site thyroid surgery

Complications of surgery for gastro-entero-pancreatic neuroendocrine neoplasias

SimLife model: introducing a new teaching device in endocrine surgery simulation

Contact Info

Product

Resources

About