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

Autor: Bilgic E; Steinberg Centre for Simulation and Interactive Learning, McGill University, Montreal, QC, Canada.; Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, QC, Canada., Hada T; Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, QC, Canada.; Department of Surgery, McGill University Health Centre, 1650 Cedar Ave, #L9.121, Montreal, QC, H3G 1A4, Canada., Dubé T; Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, QC, Canada., Valanci S; Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, QC, Canada.; Department of Surgery, McGill University Health Centre, 1650 Cedar Ave, #L9.121, Montreal, QC, H3G 1A4, Canada., de Azevedo B; Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, QC, Canada.; Department of Surgery, McGill University Health Centre, 1650 Cedar Ave, #L9.121, Montreal, QC, H3G 1A4, Canada., Feldman LS; Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, QC, Canada.; Department of Surgery, McGill University Health Centre, 1650 Cedar Ave, #L9.121, Montreal, QC, H3G 1A4, Canada., Vassiliou MC; Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, QC, Canada.; Department of Surgery, McGill University Health Centre, 1650 Cedar Ave, #L9.121, Montreal, QC, H3G 1A4, Canada., Fried GM; Steinberg Centre for Simulation and Interactive Learning, McGill University, Montreal, QC, Canada. gerald.fried@mcgill.ca.; Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, QC, Canada. gerald.fried@mcgill.ca.; Department of Surgery, McGill University Health Centre, 1650 Cedar Ave, #L9.121, Montreal, QC, H3G 1A4, Canada. gerald.fried@mcgill.ca.
Jazyk: angličtina
Zdroj: Surgical endoscopy [Surg Endosc] 2021 Jun; Vol. 35 (6), pp. 2645-2659. Date of Electronic Publication: 2020 Jun 01.
DOI: 10.1007/s00464-020-07685-3
Abstrakt: 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.
Databáze: MEDLINE
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