What are the Training Gaps for Acquiring Laparoscopic Suturing Skills?

Enani, Ghada; Watanabe, Yusuke; McKendy, Katherine M.; Bilgiç, Elif; Feldman, Liane S.; Fried, Gerald M.; Vassiliou, Melina C.

doi:10.1016/j.jsurg.2016.12.004

Cited by 25 publications

(14 citation statements)

References 22 publications

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“…Nevertheless, difficulties in implementing a training program for residents in gynecology are encountered in many countries. The main obstacles reported are lack of planning and structure within institutions, cost constraints, shortage of skilled professionals available for teaching and guide residents and limited residents’ working hours 24 , 25 , 27 - 30 .…”

Section: Discussionmentioning

confidence: 99%

The role of laparoscopy in the propaedeutics of gynecological diagnosis

et al. 2019

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Purpose To evaluate agreement between pre- and post-laparoscopy gynecological diagnosis in order to demonstrate the rationality of this minimally invasive technique use in gynecological propaedeutics. Methods Retrospective chart review study conducted between March 2010 and October 2016 based on a convenience sample. 315 patients undergoing surgical laparoscopy at the Center of Gynecologic Endoscopy and Family Planning of Botucatu Medical School/UNESP. Pre- and postoperative diagnoses were compared by the diagnosis agreement test considering the proportions of events. Results Laparoscopy contributed to diagnosis in 59.6% of infertility cases (P>0.05), in 93.7% of chronic pelvic pain of undetermined origin (P<0.01) and conclusively elucidated the diagnosis of acute abdomen and the ruling out of tubo-ovarian abcess (P<0.05). Laparoscopy also increased the diagnosis of pelvic-abdominal adhesions in 76.7% (P>0.05). Conclusion The use of laparoscopy considerably contributed to diagnostic elucidation, especially in cases of undetermined chronic pelvic pain.

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Section: Discussionmentioning

confidence: 99%

The role of laparoscopy in the propaedeutics of gynecological diagnosis

et al. 2019

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“…In order to address this, various needs assessments have been done, identifying that there is an unmet need to optimize the training of residents outside of the OR. Of the skills that are targeted by current simulation platforms, one major deficit in training was identified to be laparoscopic suturing (LS) [12,13,20]. A gap is also evident from our data; all participants stated that training for ALP skills happen mostly in the OR, with lack of effective resources available for learning outside of the OR.…”

Section: Discussionmentioning

confidence: 74%

Defining the key skills required to perform advanced laparoscopic procedures: a qualitative descriptive study

et al. 2020

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Background Simulation is widely used to teach and assess fundamental laparoscopic skills; however, program directors have reported that current simulation programs do not meet the needs for trainees and surgeons learning advanced laparoscopic procedures (ALP). The purpose of our study was to identify the key skills required to perform ALP, to serve as the basis to establish an advanced laparoscopic skills training program. Methods Semi-structured interviews were conducted with attending surgeons, fellows, and senior residents in general surgery, gynaecology, and urology. The questions were developed through an iterative process using relevant literature, expert opinions, and in consultation with a qualitative researcher. Interviews were conducted in person, over the phone, or by videoconference, and inductive thematic analysis was performed. Results 25 interviews were conducted with 16 attending surgeons and 9 fellows/residents from 9 institutions in Canada and USA. Twenty-one skills were identified to be important when performing ALP. The skills most commonly described by faculty were the following : (a) suturing, (b) dissection, (c) procedural expertise, (d) retraction and exposure, and (e) familiarity with relevant anatomy as viewed through the laparoscope. The skills most commonly described by trainees were the following: (a) suturing, (b) dissection, (c) procedural expertise, (d) trocar positioning, and (e) patient factors. There was a large difference between the importance the faculty attributed to the 'Retraction and Exposure' skill compared to the trainees. Conclusion This study identified key skills that are important when performing ALP. In order to address the current needs of trainees/surgeons learning ALP, this work provides the building blocks for the development of an advanced laparoscopic surgery simulation program.

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“…Current training curricula focus on basic laparoscopic skill learning such as the FLS. Therefore, there are still a lot of training gaps for acquiring laparoscopic suture techniques (5). Specialized and well-designed suture training curricula are needed.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic suture training curricula and techniques

Wang¹,

Li²,

Cai³

et al. 2018

Ann. Transl. Med

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With the development and ubiquitous use of minimally invasive surgery, the advanced laparoscopic skills such as suture is essential for performing gastrointestinal procedures. However, the steep learning curve and lack of standardized training make most residents underprepared for laparoscopic suture. Moreover, the current simulation-based training is inadequate for trainees to master these advanced skills. Thus, there is a need for laparoscopic suture training modeled with cognitive knowledge, approachable techniques and standardized steps. Here, we present a suture training curriculum with video demonstration. In this study, we developed a suture training curriculum, which are divided into two categories depending on its difficulty and application. Basic techniques are designed for novice to master the basic suture skills, and it also shortens the learning curve of advanced suture techniques. Advanced techniques focused on the application of suture in specific circumstances. Also, it could prepare residents for more complex procedures. In order to increase the efficacy of suture training, we recommend a learning method similar to Peyton's four-step approach, personalized video feedback and spaced learning in our curricula. This article demonstrates the various laparoscopic techniques and their applications from simple to complex, with a view to help residents in training. Also, the training curricula and recommendations will further help residents to improve efficiently. Thus, we recommend to incorporate the curricula into suture training courses and surgical programs.

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What are the Training Gaps for Acquiring Laparoscopic Suturing Skills?

Cited by 25 publications

References 22 publications

The role of laparoscopy in the propaedeutics of gynecological diagnosis

The role of laparoscopy in the propaedeutics of gynecological diagnosis

Defining the key skills required to perform advanced laparoscopic procedures: a qualitative descriptive study

Laparoscopic suture training curricula and techniques

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