Effectiveness of a team participation training course for laparoscopy-assisted gastrectomy.

ABSTRACT

BACKGROUND: Laparoscopy-assisted distal gastrectomy (LADG) for stomach cancer is increasingly performed in Japan and Korea. However, the procedure still is considered to be complicated, and the optimal education system for trainees has not been established to date. METHODS: The authors organized a 1-day professional training course termed the LADG Basic Lab Course for LADG beginners. The participants were required to apply as a team of two surgeons and two operating nurses. The training course consisted of lectures and a live porcine lab emphasizing use of the ultrasonically activated device and the flexible laparoscope as well as team cooperation. The quality and effectiveness of the course were evaluated 6-10 months (mean, 8.2 +/- 2.2 months) after the course using a survey form sent to a representative surgeon of each institution. RESULTS: From May 2007 to July 2008, a total of 80 colleagues (47 surgeons and 33 nurses) from 20 different centers in Japan participated in the training course. These surgeons represented 12.4 +/- 6.2 postgraduate years of education and had performed 2.7 +/- 4.9 LADGs before taking the course. In the follow-up evaluation, 12 institutions (60%) completed the survey forms. The mean operation time was reduced for eight respondents (66.7%). The number of LADGs performed per month increased in 50% of the respondents' institutions. The degree of lymph node dissection in LADG was extended for 66.7% of the respondents. The respondents answered that 100% of the first operators showed improvement in skills, as did 59.5% of the scope operators and 59.5% of the nurses. CONCLUSIONS: The training course was an effective means of introducing LADG to each institution. Training courses emphasizing explanations of key devices and teamwork may be effective for the introduction of advanced laparoscopic surgeries.