Effectiveness of a hands-on training course for laparoscopic spine surgery in a porcine model |
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Authors: | A Olinger G Pistorius W Lindemann B Vollmar U Hildebrandt M D Menger |
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Institution: | (1) Department of Trauma Surgery, University of Saarland, D-66421 Homburg/Saar, Germany, DE;(2) Department of General Surgery, University of Saarland, D-66421 Homburg/Saar, Germany, DE;(3) Institute for Clinical and Experimental Surgery, University of Saarland, D-66421 Homburg/Saar, Germany, DE |
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Abstract: | Background: Although it is widely proposed that surgeons, before introducing a novel laparoscopic technique in man, should practice in
an appropriate animal model for acquisition of the necessary technical skills, the effectiveness of those hands-on training
courses are rarely documented.
Methods: In 1995 we have organized eight hands-on training courses for laparoscopic anterior interbody spine fusion in an in vivo porcine model. A total of 72 colleagues from 50 different centers of 12 countries participated, including orthopedic, trauma,
visceral, neuro-, and vascular surgeons. Quality and effectiveness of the course were evaluated by a questionnaire after a
1.5- to 2.5-year period.
Results: During this time, 42.2% of the participating centers had applied the new technique successfully in man. Centers which participated
in the course with a team that included a skilled laparoscopic surgeon and an orthopedic or trauma surgeon introduced the
technique more frequently to clinical practice (57.9%) than those represented by only one participant (30.8%). Moreover, there
was a tendency toward a more frequent introduction of the technique to clinical practice in centers associated with university
hospitals (57.1% vs. 29.2%), indicating the requirement of a particular infrastructure for this complex interdisciplinary
procedure. Almost all participants (98.3%) agreed that for novel surgical techniques requiring advanced technical skills,
there should first be training in a large animal model before the technique is applied in man.
Conclusions: Complex laparoscopic procedures (i.e., laparoscopic spine surgery) can be successfully learned by in vivo hands-on training courses. We propose that for refinements and modifications of the technique (e.g., the lumboscopic approach),
there should also first be training in a large animal model before these are applied in man.
Received: 30 July 1997/Accepted: 26 March 1998 |
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Keywords: | : Hands-on training course — Minimal invasive surgery — Laparoscopic anterior interbody spine fusion — Porcine model |
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