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1.
Brain Sci ; 14(7)2024 Jun 23.
Artículo en Inglés | MEDLINE | ID: mdl-39061368

RESUMEN

BACKGROUND: Technological advancements have been rapidly integrated within the neurosurgical education track since it is a high-risk specialty with little margin for error. Indeed, simulation and virtual reality during training can improve surgical performance and technical skills. Our study aims to investigate the impact of neurosurgical technology-based simulation activities on medical students. METHODS AND MATERIALS: The "Suturing Mission-The Symposium" was a three-day event held at Humanitas University. Participants had access to live-streamed conferences held by worldwide experts in several fields of neurosurgery and practical simulations of dura mater sutures, microvascular anastomosis, and augmented reality neurosurgical approaches. An anonymous survey was conducted at the beginning and end of the event. RESULTS: 141 medical students with a mean age of 21 participated. After the course, 110 participants (77.5%) showed interest in pursuing a surgical path, with a great prevalence in those who had planned to have a surgical career before the event (88.7% vs. 41.4%, p < 0.001). Participants were also asked about their comfort levels while handling surgical instruments, and a good outcome was reached in 72.7% of participants, with a significant difference between those who had previously attended a suture course (87.8% vs. 66.3%, p = 0.012). CONCLUSION: Training sessions on surgical simulators were effective in increasing participants' interest in pursuing a surgical path, improving their understanding of postgraduate orientation, and boosting their confidence with surgical instruments.

2.
Case Rep Womens Health ; 42: e00613, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-39021445
3.
World J Urol ; 42(1): 388, 2024 Jul 10.
Artículo en Inglés | MEDLINE | ID: mdl-38985297

RESUMEN

PURPOSE: We assessed the impact of the one-year endourological society fellowship program (ESFP) on the achievement of optimal surgical outcomes (OSO) in stone patients treated with ureteroscopy (URS). MATERIALS AND METHODS: We identified 303 stone patients treated with URS from January 2018 to June 2022 by five experienced surgeons (ES). Of those, two attended ESFP. OSO was defined as the presence of residual fragments ≤ 4 mm at 1-month post-operative imaging (Ultrasound + X - Ray or CT scan). Descriptive statistics explored patients' characteristics and the rate of OSO according to the attendance of ESFP. Uni- and multivariate logistic regression analyses (UVA and MVA) tested the impact of stone characteristics, surgical data, ESFP, and imaging technique on the rate of OSO. The LOWESS curve explored the graphical association between stone size and the multivariable-adjusted probability of OSO in the two groups of surgeons. RESULTS: Of 303 patients, 208 (69%) were treated by the two surgeons who attended ESFP. OSO was achieved in 66% and 52% of patients treated by ES with and without ESFP, respectively (p = 0.01). At UVA, ESFP (OR = 1.78; 95% CI = 1.09-2.90), stone diameter (OR = 0.92; 95% CI = 0.88-0.96), stone location (kidney vs. ureter; OR = 0.34; 95% CI = 0.21-0.58), imaging technique (CT scan vs. Ultrasound + X-Ray; OR = 0.28; 95% CI = 0.16-0.47) predicted OSO achievement (all p < 0.05). At MVA analyses, ESFP was associated with OSO (OR = 2.24; 95% CI = 1.29-3.88; p < 0.05), along with the other aforementioned variables. The LOWESS curve showed that the greater the stone size, the greater the difference in OSO in the two groups of surgeons. CONCLUSIONS: ESFP positively affects OSO achievement after URS, especially in patients with a high stone burden.


Asunto(s)
Becas , Cálculos Ureterales , Ureteroscopía , Urología , Humanos , Femenino , Persona de Mediana Edad , Masculino , Urología/educación , Resultado del Tratamiento , Estudios Retrospectivos , Cálculos Ureterales/cirugía , Cálculos Ureterales/diagnóstico por imagen , Cálculos Renales/cirugía , Cálculos Renales/diagnóstico por imagen , Adulto , Sociedades Médicas , Anciano
4.
BMC Med Educ ; 24(1): 721, 2024 Jul 03.
Artículo en Inglés | MEDLINE | ID: mdl-38961425

RESUMEN

BACKGROUND: With its minimally invasive approach, laparoscopic surgery has transformed the medical landscape. As the demand for these procedures escalates, there is a pressing need for adept surgeons trained in laparoscopic techniques. However, current training often falls short of catering to medical school education. This study evaluates the impact of a custom-designed laparoscopic training workshop on medical students' surgical skills and career aspirations. METHODS: This prospective experimental study was conducted at the E-Da hospital in Kaohsiung City, Taiwan. Medical students from Taiwanese medical schools undergoing Clerk 5, Clerk 6, and Postgraduate Year 1 and 2 were invited to participate. Medical students (n = 44) underwent an endoscopic skill training workshop consisting of lectures, box training, and live tissue training. The trainees performed multiple tasks before and after training using our objective evaluation system. The primary outcome was assessed before and after training through a questionnaire assessing the influence of training on students' interest in surgery as a career. The secondary outcome measured improvement in skill acquisition, comparing the task completion time pre- and post-workshop. For the primary outcome, descriptive statistics were used to summarize the questionnaire responses, and paired t-tests were performed to determine significant changes in interest levels post-workshop. For the secondary outcome, paired t-tests were used to compare the time recorded pre- and post-training. RESULTS: Post-training, participants exhibited significant proficiency gains, with task completion times reducing notably: 97 s (p = 0.0015) for Precision Beads Placement, 88.5 s (p < 0.0001) for Beads Transfer Exercise, 95 s (p < 0.0001) for Precision Balloon Cutting, and 137.8 s (p < 0.0001) for Intracorporeal Suture. The primary outcome showcased an increased mean score from 8.15 pre-workshop to 9.3 post-workshop, indicating a bolstered interest in surgery as a career. Additionally, post-training sentiment analysis underscored a predominant inclination toward surgery among 88% of participants. CONCLUSION: The custom-designed laparoscopic workshop significantly improved technical skills and positively influenced students' career aspirations toward surgery. Such hands-on training workshops can play a crucial role in medical education, bridging the gap between theoretical knowledge and practical skills and potentially shaping the future of budding medical professionals.


Asunto(s)
Selección de Profesión , Competencia Clínica , Laparoscopía , Estudiantes de Medicina , Humanos , Laparoscopía/educación , Estudios Prospectivos , Femenino , Taiwán , Masculino , Educación de Pregrado en Medicina/métodos , Adulto Joven , Adulto
5.
Pediatr Surg Int ; 40(1): 193, 2024 Jul 16.
Artículo en Inglés | MEDLINE | ID: mdl-39014287

RESUMEN

PURPOSE: To study the published literature for various models used for simulation and training in the field of pediatric colorectal surgery. METHOD: A PubMed search was conducted for studies of simulation models in anorectal malformation on 24 March 2024 with the search words 'simulation pediatric colorectal surgery' followed by another search on 'simulation AND anorectal malformation' that gave 22 and 14 results, respectively (total 36). After removing 4 duplicate publications, 12 were found relevant to simulation and training in colorectal diseases. One publication relevant to the topic was added from literature, thirteen articles were studied. RESULTS: Of these, 5; 1; 4; and 3 were on inanimate models; animate model; 3D reconstructions; and training, respectively. Simulation models are available for posterior sagittal anorectoplasty. The same inanimate model was used in five articles. The animate model was based on a chicken cadaver. 3D models have been made for personalized preoperative assessment and to understand the imaging in anorectal malformation. One 3D model was made by regeneration of organoid epithelium. Training modules were made to evaluate surgical dissection, standardize surgical techniques, and improve proficiency. CONCLUSION: Simulation models are an important tool for teaching the steps of surgery and discussing the nuances of operative complications among mentors and peers. With advances in this field, the development of high-fidelity models, more training modules, and consensus on surgical techniques will benefit surgical training.


Asunto(s)
Malformaciones Anorrectales , Modelos Anatómicos , Entrenamiento Simulado , Humanos , Malformaciones Anorrectales/cirugía , Entrenamiento Simulado/métodos , Cirugía Colorrectal/educación , Cirugía Colorrectal/métodos
6.
Hum Factors ; : 187208241263684, 2024 Jul 22.
Artículo en Inglés | MEDLINE | ID: mdl-39038166

RESUMEN

OBJECTIVE: This review surveys the literature on sensorimotor challenges impacting performance in laparoscopic minimally invasive surgery (MIS). BACKGROUND: Despite its well-known benefits for patients, achieving proficiency in MIS can be challenging for surgeons due to many factors including altered visual perspectives and fulcrum effects in instrument handling. Research on these and other sensorimotor challenges has been hindered by imprecise terminology and the lack of a unified theoretical framework to guide research questions in the field. METHOD: We conducted a systematic survey of the MIS literature, focusing on studies investigating sensorimotor challenges affecting laparoscopic performance. To provide a common foundation for cross-study comparisons, we propose a standardized taxonomy that distinguishes between different experimental paradigms used in the literature. We then show how the computational motor learning perspective provides a unifying theoretical framework for the field that can facilitate progress and motivate future research along clearer, hypothesis-driven lines. RESULTS: The survey identified diverse sensorimotor perturbations in MIS, which can be effectively categorized according to our proposed taxonomy. Studies investigating monitor-, camera-, and tool-based perturbations were systematically analyzed, elucidating their impact on surgical performance. We also show how the computational motor learning perspective provides deeper insights and potential strategies to mitigate challenges. CONCLUSION: Sensorimotor challenges significantly impact MIS, necessitating a systematic, empirically informed approach. Our proposed taxonomy and theoretical framework shed light on the complexities involved, paving the way for more structured research and targeted training approaches to enhance surgical proficiency. APPLICATION: Understanding the sensorimotor challenges inherent to MIS can guide the design of improved training curricula and inform the configuration of setups in the operating room to enhance surgeon performance and ultimately patient outcomes. This review offers key insights for surgeons, educators, and researchers in surgical performance and technology development.

7.
Cureus ; 16(6): e62098, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38989329

RESUMEN

INTRODUCTION: The training box is an effective tool used by surgical trainees. Suturing training is the common method of practicing laparoscopic surgery; however, the cost of needles and threads for long-term practice remains a problem. In this study, we incorporated the original Japanese training for laparoscopic surgery by making an origami paper crane (laparoscopic origami training (LOT)) and evaluated its effect on the clinical results as a long-term practice. METHODS: LOT was performed using a single 7.5 × 7.5 cm origami paper in the training box of laparoscopic surgery. In the bench-top study, the total time required to make one paper crane was measured and evaluated, and a self-efficacy questionnaire was designed to analyze the efficacy of LOT. In clinical practice, we retrospectively compared two resident groups, one that had previously trained on LOT (trained group) and the other that did not (less-trained group), by analyzing the pneumoperitoneum time (PT) for 10 cases. RESULTS: After making paper cranes in approximately 100 cases, the making time was reduced to approximately 10 min. Long-term results analyzing up to 1500 cases revealed that in addition to shortening the time required to make a paper crane, the shape of the crane also improved. Consequently, the median PT was significantly shorter in the trained group than in the less-trained group (129.0 (62-287) versus 208.5 (127-343) min; p<0.001). CONCLUSION: LOT contributed to introducing safe laparoscopic surgery to residents and improved their laparoscopic outcomes. We believe that this is a useful practice methodology that can be recommended to general physicians who wish to practice laparoscopic surgeries.

9.
Artículo en Inglés | MEDLINE | ID: mdl-38995862

RESUMEN

BACKGROUND: Indocyanine green (ICG) is a visible near-infrared fluorescent dye. Several studies have reported its benefit in identifying important anatomical structures, tissue vascularization, and sentinel lymph nodes in the case of tumors. Studies have shown that ICG is critical and safe in gynecologic surgeries. However, research on how ICG dye can help surgeons in laparoscopic surgeries correctly identify the course of the ureter has yet to be further investigated. METHOD: This cross-sectional study enrolled 62 gynecology attending and resident surgeons who were asked to identify the course of the ureter on images of laparoscopic surgeries. The results were then compared with images in which ICG dye highlighted the course of the ureter. The purpose of this study was to detect the ability of surgical assistants and residents to adequately identify the course of the ureter in laparoscopic pelvic surgeries. RESULTS: No statistically significant differences were found in terms of year of residency, years of experience, number of laparoscopic procedures attended, and correct identification of ureter course. ICG proved useful in identifying the correct ureteral trajectory. CONCLUSIONS: ICG can be a valuable tool to improve the correct identification of ureters and improve surgical outcomes.

10.
J Family Reprod Health ; 18(2): 80-84, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-39011407

RESUMEN

Objective: To assess the impact of a hysteroscopic myoma resection (HMR) two-day training course on non-technical (cognitive) surgical skills among gynecologists. Materials and methods: A 2-day educational course was held in which 95 consultant gynecologic surgeons and beginner infertility fellowship residents took part. Among all 80 participants (84.2%) had ever performed diagnostic hysteroscopy and 30 (31.3%) had performed non-resectoscopic operative hysteroscopy. The training program included instructive speeches, simulated surgical presentations, and a live hands-on myomectomy workshop. Non-technical skills were assessed two times, once before and the other after the course through two written tests with 10 multiple-choice questions for each. Results: Concerning the 95 participants, 43 (47.3%) took the pre-course test and all of them (100%) took the post-course one. The mean score improved significantly from 3 (interquartile range [IQR], 0-4.0) to 7 (IQR, 5.0- 8.0) [bootstrap p<0.0001] for each of the randomly chosen pairings. The majority of candidates showed significantly improved cognitive skills after the HMR course despite their poor cognitive skills before the course. According to further analysis, there were significant enhancements in grades for all topics, especially regarding the basic principles of the procedure and management of complications (bootstrap p<0.0001). The odds ratio for the pre- versus post-course mean test results was 5.23. Due to the confidentiality stipulation, the pre- and post-course scores were not matched. Conclusion: A two-day continuing medical educational course could be efficient in improving the nontechnical (cognitive) skills for HMR.

11.
Artículo en Inglés | MEDLINE | ID: mdl-39016241

RESUMEN

OBJECTIVE: To evaluate the utility of low-cost simulation models to teach surgical techniques for placenta accreta spectrum (PAS), included in a multimodal education workshop for PAS. METHODS: This was an observational, survey-based study. Participants were surveyed before and after the use of low-fidelity mannequins to simulate two surgical techniques for PAS (one-step conservative surgery [OSCS] and modified subtotal hysterectomy [MSTH]), within a multimodal educational workshop. The workshops included pre-course preparation, didactics, simulated practice of the techniques using low-cost models, and viewing live surgery. RESULTS: Six OSCS/MSTH training workshops occurred across six countries and a total of 270 participants were surveyed. The responses of 127 certified obstetricians and gynecologists (OB-GYNs) were analyzed. Participants expressed favorable impressions of all components of the simulated session. Perceived anatomical simulator fidelity, scenario realism, educational component effectiveness, and self-assessed performance improvement received ratings of 4-5 (positive end of the Likert scale) from over 90% of respondents. When asked about simulation's role in technique comprehension, comfort level in technique performance, and likelihood of recommending this workshop to others, more than 75% of participants rated these aspects with a score of 4-5 (positively) on the five-point scale. CONCLUSION: Low-cost simulation, within a multimodal education strategy, is a well-accepted intervention for teaching surgical techniques for PAS.

12.
Curr Urol Rep ; 2024 Jul 17.
Artículo en Inglés | MEDLINE | ID: mdl-39017800

RESUMEN

PURPOSE OF REVIEW: High rates of professional burnout and career choice regret among urology residents may increase professional dissatisfaction, shorten career longevity, and exacerbate urology workforce shortages. Understanding the prevalence of and risk factors for burnout may help develop interventions. RECENT FINDINGS: Up to 48% of contemporary U.S. urology residents experience burnout symptoms, including up to 70% of second-year residents. Among overlapping personal, professional, institutional, and lifestyle risk factors, barriers to accessing medical and mental health care are frequently cited as an important association in residents. Limited intervention studies suggest that providing basic needs, such as on-call meals, and facilitating physical wellness and social engagement among residents may result in sustained reductions in burnout. Urology residents continue to experience high rates of burnout and career choice regret among medical specialties. Evidence-based interventions and sustainable policies that address primary risk factors are urgently needed.

13.
Head Neck ; 2024 Jun 06.
Artículo en Inglés | MEDLINE | ID: mdl-38842188

RESUMEN

BACKGROUND: Fluorescence-guided surgery (FGS) can help surgeons to discriminate tumor tissue from adjacent normal tissues using fluorescent tracers. METHODS: We developed a surgical training model, manufactured using sustainable vegetable organic material with indocyanine green (ICG)-containing "tumor." Surgeons evaluated the model with both the closed-field and endoscopic fluorescence imaging devices and assessed its efficacy to identify residual tumor after enucleation using electrocautery. RESULTS: Strong correlations of fluorescence were obtained at all working distance (3, 5, 7, and 10 cm), showing the robustness of fluorescence signal for the closed-field and endoscopic fluorescence imaging devices. The higher fluorescence signals were obtained in the wound bed in the closed-field fluorescence imaging device and the residual tumor could be clearly identified by fluorescence endoscopy. CONCLUSIONS: Our FGS training model may provide experience for surgeons unfamiliar with optical surgery and subsequent tissue interactions. The model seemed particularly helpful in teaching surgeons the principles of FGS.

14.
Head Face Med ; 20(1): 35, 2024 Jun 03.
Artículo en Inglés | MEDLINE | ID: mdl-38831370

RESUMEN

BACKGROUND: In reconstructive surgery, improvements are needed in the effective teaching of free flap surgery. There is a need for easily accessible and widely available training without high financial costs or ethical concerns while still providing a realistic experience. Our aim was to develop an appropriate training model for microvascular flaps. METHODS: We identified pig head halves as most appropriate regarding availability, cost, and realism. These accrue largely by the food industry, so no animals need to be sacrificed, making it more ethical from an animal welfare perspective. We evaluated the suitability as flap donor site and analyzed the vascular anatomy of 51 specimens. RESULTS: Anatomical evaluation revealed a reliable and constant vascular anatomy, allowing the design of a flap model that can effectively illustrate the entire process of microvascular flap surgery. The process was divided into 6 key steps. The flap can be harvested after marking the vascular pedicle 5.3 cm from the lateral corner of the mouth. Skin island design and subsequent tissue dissection follow until a fasciocutaneous flap is raised, similar to a radial flap. Upon completion of flap harvesting, it can be freely transferred for defect reconstruction. Microvascular anastomosis can be performed on recipient vessels in the cervical region, and the difficulty can be individually adjusted. CONCLUSIONS: The developed training model is a reasonable compromise in terms of surgical realism, availability, didactic value, and cost/time effectiveness. We believe it is a powerful and effective tool with high potential for improving surgical education and training.


Asunto(s)
Colgajos Tisulares Libres , Modelos Animales , Procedimientos de Cirugía Plástica , Animales , Porcinos , Colgajos Tisulares Libres/irrigación sanguínea , Procedimientos de Cirugía Plástica/educación , Procedimientos de Cirugía Plástica/métodos , Microcirugia/educación , Microcirugia/métodos
15.
Front Pediatr ; 12: 1402596, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38887562

RESUMEN

Introduction: Surgical education is undergoing a transformation, moving away from traditional models towards more modern approaches that integrate experiential and didactic methods. This shift is particularly pertinent in the realm of fetal and neonatal surgery, where specialized training is crucial. Historical training methods, such as cadaveric dissection, have been prevalent for centuries, but newer innovations, including animal and non-animal simulation models, are gaining prominence. This manuscript aims to explore the use of both animal and non-animal models in surgical education, with a specific focus on fetal and neonatal surgery. Animal models: The use of animal models in surgical training has a long history, dating back to Halsted's introduction in 1889. These models, often utilizing large animals like swine and dogs, offer valuable insights into fetal and neonatal surgeries. They allow for the study of long-term outcomes and the simulation of various diseases and anomalies, providing essential training experiences not readily available in human surgeries. However, there are notable limitations, including anatomical and physiological differences from humans, ethical considerations, and substantial infrastructure and maintenance costs. Simulation models: Simulation-based training offers several benefits, including standardized and safe learning environments without risks to real patients. Bench models, using synthetic materials or non-living animal tissue, provide cost-effective options for skills development. Virtual reality and 3-D printing technologies further enhance simulation experiences, allowing for the replication of complex clinical scenarios and patient-specific anatomies. While these models offer significant advantages, they lack the complexity of biological systems found in animal models. Conclusion: In conclusion, both animal and non-animal simulation models play crucial roles in enhancing surgical education, particularly in fetal and neonatal surgery. While advancements in non-animal technologies are important for ethical reasons, the continued necessity of animal models in certain areas should be acknowledged. By responsibly integrating these models into training programs, surgical education can be further enriched while upholding ethical standards and ensuring optimal patient outcomes.

16.
Pediatr Surg Int ; 40(1): 155, 2024 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-38856770

RESUMEN

PURPOSE: The availability of children's surgical care in lower middle-income countries is lacking. The authors describe a hub and spoke global training initiative in children's surgery for adult teams from district hospitals (spokes) comprising general and orthopaedic surgeons, anaesthetists, and nurses and specialist children's surgical trainers from tertiary centres (hubs) in delivering the course. METHODS: The training course developed in Vellore, trained several sets of district hospital adult teams and trainer teams in India. Six specialist children's surgical trainer teams were invited from African countries to the course delivered in Vellore, India. The aim was to train them to deliver the course in their countries. RESULTS: Participants underwent a precourse 'train the trainer' program, observed and assessed the suitability of the district hospital training course. The program received positive feedback, government supported planning of similar courses in some of the countries and discussions in others. CONCLUSION: The availability of children's surgical care is similarly limited in the Asian and African continent, and the regions have shared challenges of disease burden, lack of access, poverty, deficient infrastructure, and trained human resources. They would benefit from this 'South to South' collaboration to impart training skills and modules to the children's surgical trainers.


Asunto(s)
Pediatría , Humanos , India , África , Pediatría/educación , Niño , Países en Desarrollo , Hospitales de Distrito
17.
J Hand Microsurg ; 16(2): 100024, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38855522

RESUMEN

In recent years, new orthopaedic surgical simulation and virtual reality (VR) training models have emerged to provide unlimited education medium to an unlimited number of trainees with no time limit, especially in response to trainee work-hour restrictions. Surgical simulators range from simple wooden boxes to animal and cadaver models to three-dimensional-printed and VR simulators. The coronavirus disease 2019 pandemic further highlighted the need for at-home learning tools for orthopaedic surgical trainees. Advancement in simulating shoulder and knee arthroscopies using VR simulators surpasses the other fields in orthopaedic surgery. Despite the high degree of precision needed to operate at a microscopic level involving vessels, nerves, and the small bones of the hand, the simulation tools have limited advancement in the field of orthopaedic hand surgery. This narrative review summarizes the status of surgical simulation and training techniques available to orthopaedic hand surgical trainees, factors affecting their application, and areas in hand surgery that still lag behind their surgical subspecialty counterparts.

18.
Surg Innov ; : 15533506241264382, 2024 Jun 21.
Artículo en Inglés | MEDLINE | ID: mdl-38906119

RESUMEN

BACKGROUND: Surgical reconstruction is a crucial stage in various surgeries, including pancreaticoduodenectomy, as it can significantly affect the surgical results. The objective was to design a suture force feedback (SFF) device that can precisely measure the suture force during surgical closures. Afterward, the device was used to train junior surgeons in surgical closure techniques. METHODS: The SFF was used to capture the suture force data of experienced surgeons. This data was utilized to train and assess junior surgeons. The SFF device had 2 tactile-based force sensors that measured the applied force. Whenever the applied force was not within the optimal force range, the device provided feedback to the surgeon. A workshop was conducted to train junior surgeons in surgical closure techniques to improve their suturing skills. RESULTS: Thirty-seven junior surgeons were enrolled in this training, of whom only 24 completed the 30-day training program. The pre-assessment results revealed that the force exerted by junior surgeons during suture knot-tying was uneven compared with that of the experienced surgeons, with a significant difference in the force exerted per knot throw (P = 0.005. Before the training program, junior surgeons applied a force of 3.89 ± 0.43 N, which was more than twice the force applied by experienced surgeons (1.75 ± 0.12 N). However, after completing the 30-day training program, their force improved to 2.35 ± 0.13 N. CONCLUSIONS: The SFF device was shown to be an encouraging training tool for improving the surgical closure dexterity and technique of the participating junior surgeons.

19.
Langenbecks Arch Surg ; 409(1): 186, 2024 Jun 13.
Artículo en Inglés | MEDLINE | ID: mdl-38869683

RESUMEN

PURPOSE: The purpose of this study was to assess the effect of training with a personal, portable laparoscopic endo-trainer (PLET) on residents' laparoscopic skills. METHODS: The study took place at a tertiary-care academic university hospital in Switzerland. All participants were randomized to either a home- or hospital-based PLET training group, and surgical skill performance was assessed using five laparoscopic exercises. 24 surgical residents, 13 females and 11 males, were enrolled at any training stage. Nine residents completed the assessments. Endpoints consisted of subjective and objective assessment ratings as well as exercise time and qualitative data up to 12 weeks. The primary outcome was the difference in exercise time and secondary outcomes included performance scores as well as qualitative data. RESULTS: The hospital-based training group performed exercises number 1, 3 and 4 faster at 12 weeks than at baseline (p = .003, < 0.001 and 0.024). Surgical skill performance was not statistically significantly different in any of the endpoints between the hospital- and home-based training groups at 12 weeks. Both the subjective and objective assessment ratings significantly improved in the hospital-based training group between baseline and 12 weeks (p = .006 and 0.003, respectively). There was no statistically significant improvement in exercise time as well as subjective and objective assessment ratings over time in the home-based training group. The qualitative data suggested that participants who were randomized to the hospital-based training group wished to have the PLET at home and vice versa. Several participants across groups lacked motivation because of their workload or time constraints, though most believed the COVID-19 pandemic had no influence on their motivation or the time they had for training. CONCLUSION: The PLET enhances laparoscopic surgical skills over time in a hospital-based training setting. In order to understand and optimize motivational factors, further research is needed. TRIAL REGISTRATION: This trial was retrospectively registered on clinicaltrials.gov (NCT06301230).


Asunto(s)
Competencia Clínica , Internado y Residencia , Laparoscopía , Humanos , Femenino , Masculino , Laparoscopía/educación , Suiza , Adulto , COVID-19
20.
J Robot Surg ; 18(1): 267, 2024 Jun 25.
Artículo en Inglés | MEDLINE | ID: mdl-38916774

RESUMEN

Immersive intracorporeal vision is a key feature of robotic surgery, limited today to only one trainee per operation when the dual console is available. We developed a tool that provides a virtually unlimited number of surgeons with the operator's view, with the possibility to also watch the surgeon's hand movements and the operating table. In this study, we aim to assess trainees' reaction to this innovative training method. Medical students and surgery residents were offered an immersive experience with head-mounted devices, showing a didactic video in a 360° virtual space with 3D intracorporeal robotic vision, the surgeon's hand movements and the surrounding operating room during a robotic rectal resection with total mesorectal excision. Subsequently, participants were asked to fill a questionnaire evaluating the user's reaction to the new training tool including the validated System Usability Scale (SUS) and Simulator Sickness Questionnaire (SSQ), and non-validated questions. 102 participants took part in the training and the assessment questionnaires, 94 (92%) medical students and 8 (8%) surgery residents. Users' feedback was overall positive. In the engagement and intention to use items, almost 90% of the respondents voted for a complete or near complete agreement. The median SUS score was 80 [IQR 70-90]. The median SSQ score was 44.88 [IQR 22.44-82.28]. Exposing trainees to immersive robotic vision of the surgical field had a positive reaction from our audience. Our initial results encourage further implementing this technology in surgical training of medical students and residents to prove its efficacy.


Asunto(s)
Procedimientos Quirúrgicos Robotizados , Estudiantes de Medicina , Realidad Virtual , Procedimientos Quirúrgicos Robotizados/educación , Procedimientos Quirúrgicos Robotizados/métodos , Humanos , Proyectos Piloto , Encuestas y Cuestionarios , Internado y Residencia/métodos , Masculino , Femenino , Adulto , Imagenología Tridimensional/métodos
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