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Characterization of technical skill progress in a standardized rabbit model for training in laparoscopic duodenal atresia repair

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...

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Autores principales: Etlinger, Péter, Barroso, Catarina, Miranda, Alice, Moreira Pinto, João, Lamas-Pinheiro, Ruben, Ferreira, Hélder, Leão, Pedro, Kovács, Tamás, Juhász, László, Sasi Szabó, László, Farkas, András, Vajda, Péter, Kálmán, Attila, Géczi, Tibor, Simonka, Zsolt, Cserni, Tamás, Nógrády, Miklós, Fodor, Gergely H., Szabó, Andrea, Correia-Pinto, Jorge
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8921057/
https://www.ncbi.nlm.nih.gov/pubmed/33999254
http://dx.doi.org/10.1007/s00464-021-08530-x
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author Etlinger, Péter
Barroso, Catarina
Miranda, Alice
Moreira Pinto, João
Lamas-Pinheiro, Ruben
Ferreira, Hélder
Leão, Pedro
Kovács, Tamás
Juhász, László
Sasi Szabó, László
Farkas, András
Vajda, Péter
Kálmán, Attila
Géczi, Tibor
Simonka, Zsolt
Cserni, Tamás
Nógrády, Miklós
Fodor, Gergely H.
Szabó, Andrea
Correia-Pinto, Jorge
author_facet Etlinger, Péter
Barroso, Catarina
Miranda, Alice
Moreira Pinto, João
Lamas-Pinheiro, Ruben
Ferreira, Hélder
Leão, Pedro
Kovács, Tamás
Juhász, László
Sasi Szabó, László
Farkas, András
Vajda, Péter
Kálmán, Attila
Géczi, Tibor
Simonka, Zsolt
Cserni, Tamás
Nógrády, Miklós
Fodor, Gergely H.
Szabó, Andrea
Correia-Pinto, Jorge
author_sort Etlinger, Péter
collection PubMed
description 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.
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spelling pubmed-89210572022-03-17 Characterization of technical skill progress in a standardized rabbit model for training in laparoscopic duodenal atresia repair Etlinger, Péter Barroso, Catarina Miranda, Alice Moreira Pinto, João Lamas-Pinheiro, Ruben Ferreira, Hélder Leão, Pedro Kovács, Tamás Juhász, László Sasi Szabó, László Farkas, András Vajda, Péter Kálmán, Attila Géczi, Tibor Simonka, Zsolt Cserni, Tamás Nógrády, Miklós Fodor, Gergely H. Szabó, Andrea Correia-Pinto, Jorge Surg Endosc Article 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. Springer US 2021-05-17 2022 /pmc/articles/PMC8921057/ /pubmed/33999254 http://dx.doi.org/10.1007/s00464-021-08530-x Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Etlinger, Péter
Barroso, Catarina
Miranda, Alice
Moreira Pinto, João
Lamas-Pinheiro, Ruben
Ferreira, Hélder
Leão, Pedro
Kovács, Tamás
Juhász, László
Sasi Szabó, László
Farkas, András
Vajda, Péter
Kálmán, Attila
Géczi, Tibor
Simonka, Zsolt
Cserni, Tamás
Nógrády, Miklós
Fodor, Gergely H.
Szabó, Andrea
Correia-Pinto, Jorge
Characterization of technical skill progress in a standardized rabbit model for training in laparoscopic duodenal atresia repair
title Characterization of technical skill progress in a standardized rabbit model for training in laparoscopic duodenal atresia repair
title_full Characterization of technical skill progress in a standardized rabbit model for training in laparoscopic duodenal atresia repair
title_fullStr Characterization of technical skill progress in a standardized rabbit model for training in laparoscopic duodenal atresia repair
title_full_unstemmed Characterization of technical skill progress in a standardized rabbit model for training in laparoscopic duodenal atresia repair
title_short Characterization of technical skill progress in a standardized rabbit model for training in laparoscopic duodenal atresia repair
title_sort characterization of technical skill progress in a standardized rabbit model for training in laparoscopic duodenal atresia repair
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8921057/
https://www.ncbi.nlm.nih.gov/pubmed/33999254
http://dx.doi.org/10.1007/s00464-021-08530-x
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