Cholangioscopy under direct visualization: skill progress during a dedicated Image-Guided Surgery Course.

Autor: Gimenez ME; Institute of Image-Guided Surgery, IHU-Strasbourg, 1, Place de l'Hôpital, 67000, Strasbourg, France. marianoegimenez@gmail.com.; DAICIM Foundation (Training, Research and Clinical Activity in Minimally Invasive Surgery), Buenos Aires, Argentina. marianoegimenez@gmail.com.; Research Institute Against Digestive Cancer, IRCAD, Strasbourg, France. marianoegimenez@gmail.com., Uribe Rivera AK; Institute of Image-Guided Surgery, IHU-Strasbourg, 1, Place de l'Hôpital, 67000, Strasbourg, France., Montanelli J; Institute of Image-Guided Surgery, IHU-Strasbourg, 1, Place de l'Hôpital, 67000, Strasbourg, France., Swanström LL; Institute of Image-Guided Surgery, IHU-Strasbourg, 1, Place de l'Hôpital, 67000, Strasbourg, France., Mutter D; Institute of Image-Guided Surgery, IHU-Strasbourg, 1, Place de l'Hôpital, 67000, Strasbourg, France.; Department of Digestive and Endocrine Surgery, University Hospitals of Strasbourg, Strasbourg, France.; Research Institute Against Digestive Cancer, IRCAD, Strasbourg, France., Seeliger B; Institute of Image-Guided Surgery, IHU-Strasbourg, 1, Place de l'Hôpital, 67000, Strasbourg, France.; Department of Digestive and Endocrine Surgery, University Hospitals of Strasbourg, Strasbourg, France.; Research Institute Against Digestive Cancer, IRCAD, Strasbourg, France.; ICube, UMR 7357 CNRS, University of Strasbourg, Strasbourg, France.; Institute for Viral and Liver Diseases, Inserm U1110, Strasbourg, France.
Jazyk: angličtina
Zdroj: Surgical endoscopy [Surg Endosc] 2023 Oct; Vol. 37 (10), pp. 8116-8122. Date of Electronic Publication: 2023 Sep 01.
DOI: 10.1007/s00464-023-10357-7
Abstrakt: Aims: Training programs are essential to introduce new methods for bile duct clearance. Visual examination via cholangioscopy is ideal to diagnose and treat biliary tract diseases such as cancer and choledocholithiasis. However, surgeons rarely use cholangioscopes. Specific training is required to master laparoscopic and percutaneous cholangioscopy. This study aims to assess skill acquisition and retention during cholangioscopy training in the Image-Guided Therapies Masterclass.
Methods: This prospective study enrolled 17 physicians undergoing training in interventional treatments of biliary diseases. A novel disposable cholangioscope and access kit were used with a biliary tract model including two simulated common bile duct (CBD) stones. The curriculum required visualization of all critical structures before removal of one stone with a Dormia basket. After informed consent, demographic data and time to exercise completion were recorded on each of two subsequent training days. Task-specific questions were measured at the completion of training using a Likert scale (strongly disagree to strongly agree, 1-5 points).
Results: All participants successfully completed the task (6F/11 M, age 36 ± 5 years; 13 surgeons, 4 interventional radiologists; median experience with percutaneous procedures 2 years, range 0-20). Significant improvement in mean task completion time was observed (day 1: 172 ± 59 s, day 2: 89 ± 45 s; P < 0.0001). All task-specific questions were answered with a median rating of 5/5: "The platform facilitates cholangioscopy" and "This training method accelerates gain in proficiency and is useful for residents/fellows" (IQR 5-5), "This platform is useful to measure the proficiency level" and "There is an application for simulation in percutaneous surgery training" (IQR 4.5-5), "The platform is user-friendly" and "The model quality recreates realistic scenarios" (IQR 4-5).
Conclusion: Cholangioscopic bile duct exploration and stone retrieval were achieved by all participants using a dedicated training program and physical simulator. Significant skill progress was observed during 2 days of dedicated training.
(© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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