Simulation-trained junior residents perform better than general surgeons on advanced laparoscopic cases |
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Authors: | Camilo?Boza Felipe?León Erwin?Buckel Arnoldo?Riquelme Fernando?Crovari Jorge?Martínez Rajesh?Aggarwal Teodor?Grantcharov Nicolás?Jarufe Email author" target="_blank">Julián?VarasEmail author |
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Institution: | 1.Experimental Surgery and Simulation Center, Department of Digestive Surgery, Clinic Hospital, School of Medicine,Pontificia Universidad Católica de Chile,Santiago,Chile;2.Experimental Surgery and Simulation Center, Department of Gastroenterology, Clinic Hospital, School of Medicine,Pontificia Universidad Católica de Chile,Santiago,Chile;3.Department of Surgery, Faculty of Medicine,McGill University,Montreal,Canada;4.Steinberg Centre for Simulation and Interactive Learning, Faculty of Medicine,McGill University,Montreal,Canada;5.Department of Surgery, St. Michael’s Hospital,University of Toronto,Toronto,Canada |
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Abstract: | BackgroundMultiple simulation training programs have demonstrated that effective transfer of skills can be attained and applied into a more complex scenario, but evidence regarding transfer to the operating room is limited.ObjectiveTo assess junior residents trained with simulation performing an advanced laparoscopic procedure in the OR and compare results to those of general surgeons without simulation training and expert laparoscopic surgeons.MethodsExperimental study: After a validated 16-session advanced laparoscopy simulation training program, junior trainees were compared to general surgeons (GS) with no simulation training and expert bariatric surgeons (BS) in performing a stapled jejuno-jejunostomy (JJO) in the OR. Global rating scale (GRS) and specific rating scale scores, operative time and the distance traveled by both hands measured with a tracking device, were assessed. In addition, all perioperative and immediate postoperative morbidities were registered.ResultsTen junior trainees, 12 GS and 5 BS experts were assessed performing a JJO in the OR. All trainees completed the entire JJO in the OR without any takeovers by the BS. Six (50 %) BS takeovers took place in the GS group. Trainees had significantly better results in all measured outcomes when compared to GS with considerable higher GRS median 19.5 (18.8–23.5) vs. 12 (9–13.8) p < 0.001] and lower operative time. One morbidity was registered; a patient in the trainees group was readmitted at postoperative day 10 for mechanical ileus that resolved with medical treatment.ConclusionThis study demonstrated transfer of advanced laparoscopic skills acquired through a simulated training program in novice surgical residents to the OR. |
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