Training of a standardized natural orifice transluminal endoscopic surgery cholecystectomy using an ex vivo training unit
Training of a standardized natural orifice transluminal endoscopic surgery cholecystectomy using an ex vivo training unit
复制标题
DOI：
10.1055/s-0030-1256556
复制
发表时间：
2011-10-01
期刊：
影响因子：
9.3
通讯作者：
Feussner, H.
中科院分区：
文献类型：
--
作者：
Gillen, S.;Fiolka, A.;Feussner, H.
背景与研究目的：内窥镜-腹腔镜跨学科培训实体（ELITE）是自然孔腔内窥镜手术（NOTES）和常规腹腔镜内镜技能培训的首批培训模式之一。目前的研究旨在评估体外训练单元的手术模拟效果是否与手术室的手术实践相关，特别是谁可能从这种训练中受益。患者和方法：一组30名参与者（胃肠病学家、腹腔镜医生和新手）通过乙状结肠入路进行了标准化的NOTES胆囊切除术。15名参与者在接受ELITE训练后进行了胆囊切除术，另外15名参与者在没有接受训练的情况下进行了手术。研究的参数包括任务时间、手术过程的质量和安全性以及对ELITE训练器作为教学模型的主观评价。结果：在培训课程中，所有参与者都表现出显著的学习曲线，第一次通过的总时间为32分钟，而第四次通过的总时间为18分钟（P < 0.001）。对于猪模型的胆囊切除术，事先受过训练的参与者比没有受过训练的参与者完成手术所需的时间更短。在未接受训练的组中，发生的并发症/困难比接受过训练的组多（16对8）。由两位独立的NOTES专家进行的视频分析显示，评分者之间的效度为1.0。主观评价表明，参与者认为ELITE是适合和推荐的NOTES模拟器。结论：ELITE模型适用于NOTES胆囊切除术的训练。这种类型的模拟器训练导致较少的术中并发症。
Background and study aims: The endoscopic-laparoscopic interdisciplinary training entity (ELITE) is one of the first training models for the training of natural orifice transluminal endoscopic surgery (NOTES) and conventional laparoscopic and endoscopic skills. The current study was designed to assess whether the effect of surgical simulation with an ex vivo training unit is relevant to surgical practice in the operating room and who, in particular, might benefit from this training.Patients and methods: A group of 30 participants (gastroenterologists, laparoscopists, and novices) performed a standardized NOTES cholecystectomy via a trans-sigmoidal approach. Fifteen participants performed the cholecystectomy following training with ELITE and 15 participants performed the procedures without previous training. The parameters studied were task times, quality and safety of the surgical procedure, and subjective evaluation of the ELITE trainer as a teaching model.Results: During the training courses all participants showed a significant learning curve, with a total time needed on the first pass of 32 minutes vs. 18 minutes for the fourth pass (P < 0.001). For the cholecystectomy in the pig model, participants with prior training needed less time to complete the procedure than participants without training. In the group without training, more complications/difficulties occurred than in the group with prior training (16 vs. 8). The video analyses by two independent NOTES experts showed an inter-rater validity of 1.0. Subjective evaluation showed that participants considered ELITE to be a suitable and recommendable simulator for NOTES.Conclusions: The ELITE model is suitable for training in the NOTES cholecystectomy procedure. This type of simulator training leads to fewer intraoperative complications.