Improving operative performance using a laparoscopic hernia simulator

被引:99
作者
Hamilton, EC [1 ]
Scott, DJ [1 ]
Kapoor, A [1 ]
Nwariaku, F [1 ]
Bergen, PC [1 ]
Rege, RV [1 ]
Tesfay, ST [1 ]
Jones, DB [1 ]
机构
[1] Univ Texas, SW Med Ctr, Dept Surg, SW Ctr Minimally Invas Surg, Dallas, TX 75390 USA
关键词
laparoscopic total extraperitoneal hernia repair; skills training; global assessment; surgical education; simulation;
D O I
10.1016/S0002-9610(01)00800-5
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: Traditionally, the acquisition of surgical skill has occurred entirely in the operating room. To meet the expanding challenges of cost containment and patient safety, novel methods of surgical training utilizing ex-vivo workstations are being developed. The purpose of our study was to evaluate the impact of a laparoscopic training curriculum on surgical residents' operative performance. Methods: Twenty-one surgery residents completed baseline laparoscopic total extraperitoneal (TEP) hernia repairs. Operative performance was evaluated using a validated global assessment tool. Each resident was then randomized to a control group or a trained group. A CD ROM, video, and simulator were used for training. At the end of the study, each resident's operative performance was again evaluated. Results: Improvement was significantly greater in the trained group in five of the eight individual global assessment areas as well as the composite score (P <0.05). Questionnaire data suggested that training resulted in improved understanding of the TEP hernia repair (P = 0.01) and an increased willingness to offer the operation to patients with nonrecurrent unilateral hernias (P = 0.02). Conclusions: A multimodality laparoscopic TEP hernia curriculum improves residents' knowledge of the TEP hernia repair and comfort in per-forming the procedure, and may also improve actual operative performance. (C) 2002 Excerpta Medica, Inc. All rights reserved.
引用
收藏
页码:725 / 728
页数:4
相关论文
共 10 条
[1]   Development of a model for training and evaluation of laparoscopic skills [J].
Derossis, AM ;
Fried, GM ;
Abrahamowicz, M ;
Sigman, HH ;
Barkun, JS ;
Meakins, JL .
AMERICAN JOURNAL OF SURGERY, 1998, 175 (06) :482-487
[2]  
HAMILTON EC, IN PRESS SURG ENDOSC
[3]   Comparison of conventional anterior surgery and laparoscopic surgery for inguinal-hernia repair [J].
Liem, MSL ;
vanderGraaf, Y ;
vanSteensel, CJ ;
Boelhouwer, RU ;
Clevers, GJ ;
Meijer, WS ;
Stassen, LPS ;
Vente, JP ;
Weidema, WF ;
Schrijvers, AJP ;
vanVroonhoven, TJMV .
NEW ENGLAND JOURNAL OF MEDICINE, 1997, 336 (22) :1541-1547
[4]   Competency-based instruction in critical invasive skills improves both resident performance and patient safety [J].
Martin, M ;
Vashisht, B ;
Frezza, E ;
Ferone, T ;
Lopez, B ;
Pahuja, M ;
Spence, RK .
SURGERY, 1998, 124 (02) :313-317
[5]   Testing technical skill via an innovative ''bench station'' examination [J].
Reznick, R ;
Regehr, G ;
MacRae, H ;
Martin, J ;
McCulloch, W .
AMERICAN JOURNAL OF SURGERY, 1997, 173 (03) :226-230
[6]   TEACHING AND TESTING TECHNICAL SKILLS [J].
REZNICK, RK .
AMERICAN JOURNAL OF SURGERY, 1993, 165 (03) :358-361
[7]   Objective evaluation of a laparoscopic surgical skill program for residents and senior surgeons [J].
Rosser, JC ;
Rosser, LE ;
Savalgi, RS .
ARCHIVES OF SURGERY, 1998, 133 (06) :657-661
[8]   Laparoscopic training on bench models: Better and more cost effective than operating room experience? [J].
Scott, DJ ;
Bergen, PC ;
Rege, RV ;
Laycock, R ;
Tesfay, ST ;
Valentine, RJ ;
Euhus, DM ;
Jeyarajah, DR ;
Thompson, WM ;
Jones, DB .
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2000, 191 (03) :272-283
[9]  
SCOTT DJ, 1999, SURG FORUM, V50, P670
[10]  
SCOTT DJ, 1999, SELECTED READINGS GE, V26