Programa de formación del residente de cirugía en un laboratorio experimental de cirugía minimamente invasiva (CENDOS) |
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Authors: | José Carlos Manuel-Palazuelos Joaquín Alonso-Martín María José Fernández Díaz Santiago Revuelta-Álvarez Manuel Gómez-Fleitas |
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Institution: | a Hospital Universitario Valdecilla, Santander, Cantabria, España b Hospital Sierrallana de Torrelavega, Cantabria, España c Cátedra de Patología Quirúrgica, Universidad de Cantabria, Santander, Cantabria, España |
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Abstract: | IntroductionThe rapid development of laparoscopic surgery makes resident training programmes necessary.ObjectiveTo analyse the results of a structured programme of laparoscopic training in an experimental laboratory.Material and methodFrom 2003 until 2007, we trained 11 general surgery residents for 20 h every 3 months, for three years. The practice consisted of suture and anastomosis in Endo-Trainer with animal organs, as well as laparoscopic techniques in live animals. In the Endo-Trainer practice we evaluated the time and quality of anastomosis performance. In laparoscopic techniques (cholecystectomy and anti-reflux surgery) a task table was evaluated, from 0 (no errors) to 100 (severe lesion).ResultsIn total, 314 anastomosis were performed by the 11 residents, with a median of 28.5 per resident (24-42). The mean time for the first gastro-jejunal anastomosis was 135 min (100-140) and 65 min (57.5-105) for the first jejunal-jejunal anastomosis. Maximum learning was achieved after 45 training hours. There wer no appreciable ifferences between both types of anastomosis. There was inadequate anastomosis quality due to leakage in 17.1% during the learning period and 13.7% during the consolidation period. In the animal, 172 procedures were performed. In cholecystectomy and anti-reflux surgery the mean scores were 2.4 and 5.6 points, respectively. In the remaining procedures, subjectively evaluated by the monitors, the quality was adequate in 65%, deficient in 22% and highly deficient in 13%.ConclusionsThis structured programme of laparoscopic skills based on intestinal anastomosis allows for quicker resident training. |
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Keywords: | Entrenamiento y formació n Laboratorio experimental Cirugí a laparoscó pica |
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