[Surgical resident training program in minimally invasive surgery experimental laboratory (CENDOS)]. / Programa de formación del residente de cirugía en un laboratorio experimental de cirugía minimamente invasiva (CENDOS).

INTRODUCTION: The rapid development of laparoscopic surgery makes resident training programmes necessary. OBJECTIVE: To analyse the results of a structured programme of laparoscopic training in an experimental laboratory. MATERIAL AND METHOD: From 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). RESULTS: In 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 were no appreciable differences 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%. CONCLUSIONS: This structured programme of laparoscopic skills based on intestinal anastomosis allows for quicker resident training.

Programa de formación del residente de cirugía en un laboratorio experimental de cirugía minimamente invasiva (CENDOS) / Surgical resident training program in minimally invasive surgery experimental laboratory (CENDOS)

Introducción: el rápido avance de la cirugía laparoscópica obliga a cambiar los métodos de enseñanza de residentes. Objetivo: analizar los resultados de un programa estructurado de formación laparoscópica en laboratorio experimental. Material y método: entre 2003 y 2007, entrenamos a 11 residentes de cirugía general 20h por trimestre durante 3 años. Incluimos habilidades en suturas y anastomosis en endotrainer con órganos animales y técnicas laparoscópicas en animales vivos. En la práctica en cajas, se registraron tiempo y calidad anastomótica. En la laparoscopia realizada al animal (colecistectomía y antirreflujo), se puntuó una tabla de tareas de 0 (ningún error) a 100 (lesión grave).Resultados: los 11 residentes realizaron 314 anastomosis, con una media de 28,5 (24-42) anastomosis/residente. La mediana de tiempo para la primera anastomosis gastroyeyunal fue 135 (100-140) min y para la yeyunoyeyunal, 65 (57,5-105) min. El máximo aprendizaje se produjo transcurridas 45h de entrenamiento. No se apreciaron diferencias en la ejecución de ambas anastomosis. Se registró deficiente calidad anastomótica, determinada por existencia de fuga, en el 17,1% durante el período de aprendizaje y el 13,7% durante el de consolidación. En el animal realizaron 172 procedimientos. En colecistectomía y antirreflujo hubo una media de 2,4 y 5,6 puntos. En el resto de procedimientos, valorados subjetivamente por el monitor, la calidad de la técnica fue correcta en el 65%, mejorable en el 22% y muy mejorable en el 13%.Conclusiones: este programa estructurado de habilidades laparoscópicas basado en la ejecución de anastomosis intestinales permite acelerar la formación de los residentes (AU)

Introduction: The rapid development of laparoscopic surgery makes resident training programmes necessary. Objective: To analyse the results of a structured programme of laparoscopic training in an experimental laboratory. Material and method: From 2003 until 2007, we trained 11 general surgery residents for 20h 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).Results: In 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 135min (100–140) and 65min (57.5–105) for the first jejunal-jejunal anastomosis. Maximum learning was achieved after 45 training hours. There were no appreciable differences 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%.Conclusions: This structured programme of laparoscopic skills based on intestinal anastomosis allows for quicker resident training (AU)