Characterization of technical skill progress in a standardized rabbit model for training in laparoscopic duodenal atresia repair
Year: 2021
Type: article
Abstract: BACKGROUND: Laboratory skills training is an essential step before conducting minimally invasive surgery in clinical practice. Our main aim was to develop an animal model for training in clinically highly challenging laparoscopic duodenal atresia repair that could be useful in establishing a minimum number of repetitions to indicate safe performance of similar interventions on humans. MATERIALS AND METHODS: A rabbit model of laparoscopic duodenum atresia surgery involving a diamond-shaped duodeno-duodenostomy was designed. This approach was tested in two groups of surgeons: in a beginner group without any previous clinical laparoscopic experience (but having undergone previous standardized dry-lab training, n = 8) and in an advanced group comprising pediatric surgery fellows with previous clinical experience of laparoscopy (n = 7). Each participant performed eight interventions. Surgical time, expert assessment using the Global Operative Assessment of Laparoscopic Skills (GOALS) score, anastomosis quality (leakage) and results from participant feedback questionnaires were analyzed. RESULTS: Participants in both groups successfully completed all eight surgeries. The surgical time gradually improved in both groups, but it was typically shorter in the advanced group than in the beginner group. The leakage rate was significantly lower in the advanced group in the first two interventions, and it reached its optimal level after five operations in both groups. The GOALS and participant feedback scores showed gradual increases, evident even after the fifth surgery. CONCLUSIONS: Our data confirm the feasibility of this advanced pediatric laparoscopic model. Surgical time, anastomosis quality, GOALS score and self-assessment parameters adequately quantify technical improvement among the participants. Anastomosis quality reaches its optimal value after the fifth operation even in novice, but uniformly trained surgeons. A minimum number of wet-lab operations can be determined before surgery can be safely conducted in a clinical setting, where the development of further non-technical skills is also required.
Source: Surgical Endoscopy
Authors: Péter Etlinger, Catarina Barroso, Alice Miranda, João Moreira Pinto, Ruben Lamas-Pinheiro, Hélder Ferreira, Pedro Leão, Tamás Kovács, László Juhász, László Sasi Szabó, András Farkas, Péter Vajda, Attila Kálmán, Tibor Géczi, Zsolt Simonka, Tamás Cserni, Miklós Nógrády, Gergely H. Fodor, Andrea Szabó, Jorge Correia-Pinto
Institutions: University of Szeged, University of Minho, Hospital Braga, Universidade do Porto, Hospital-Escola da Universidade Fernando Pessoa, Institute of Public Health, University of Porto, Centro Hospitalar do Porto, University of Debrecen, University of Pecs, Semmelweis University, Royal Manchester Children's Hospital
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,860
Awards: G1167214205, G1516346500, G1578237752, G1763632427, G2440504136, G274581676, G323769159, G3326568298, G3786582701, G3840324753, G4316116677, G4724859719, New avenues for the development of personalized medical interventions for neurological, oncologic and surgical disorders – “PersonalizedNOS”, G5224927334, G5677667711, UID/Multi/50026 .: ICVS/3B?s - Laboratório Associado, Instituto de Ciências da Vida e da Saúde / Grupo de Investigação em Biomateriais, Bio, G7584003722, G7965899483, G96847669
OpenAlex ID: W3162014647