The importance of systematic operative training in laparoscopic adrenalectomy for novice surgeons
The original training program to obtain the license in endoscopic surgical skill qualification system (ESSQS) of the JSE started at 2006 at the Department of Urology of Okayama University Hospital. We reviewed the outcomes of laparoscopic adrenalectomy surgeries that were performed by the trainees...
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Published in | Japanese Journal of Endourology Vol. 32; no. 2; pp. 225 - 229 |
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Main Authors | , , , , , , , , , , , |
Format | Journal Article |
Language | Japanese |
Published |
Japanese Society of Endourology
2019
日本泌尿器内視鏡学会 |
Subjects | |
Online Access | Get full text |
ISSN | 2186-1889 2187-4700 |
DOI | 10.11302/jsejje.32.225 |
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Abstract | The original training program to obtain the license in endoscopic surgical skill qualification system (ESSQS) of the JSE started at 2006 at the Department of Urology of Okayama University Hospital. We reviewed the outcomes of laparoscopic adrenalectomy surgeries that were performed by the trainees enrolled in the program. We retrospectively evaluated the case of 76 patients who underwent laparoscopic adrenalectomy by trainees in comparison with 43 cases performed by ESSQS certified urologists from March 2009 to November 2017. The median number of cases performed by 18 trainees (6-11 years after graduation) was 4 (range : 1-9), and by 9 certified urologists was 2 (range : 1-26). There were no significant differences in the patient background between two groups. The operative time was significantly shorter in the certified group (p = 0.0122). There was no case that required blood transfusion nor conversion to open surgical approach. The operative time and blood loss were presented without following the expected learning curve when they were compared to similar training programs. The systematic education achieved favorable outcome in the trainee group. |
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AbstractList | The original training program to obtain the license in endoscopic surgical skill qualification system (ESSQS) of the JSE started at 2006 at the Department of Urology of Okayama University Hospital. We reviewed the outcomes of laparoscopic adrenalectomy surgeries that were performed by the trainees enrolled in the program. We retrospectively evaluated the case of 76 patients who underwent laparoscopic adrenalectomy by trainees in comparison with 43 cases performed by ESSQS certified urologists from March 2009 to November 2017. The median number of cases performed by 18 trainees (6-11 years after graduation) was 4 (range : 1-9), and by 9 certified urologists was 2 (range : 1-26). There were no significant differences in the patient background between two groups. The operative time was significantly shorter in the certified group (p = 0.0122). There was no case that required blood transfusion nor conversion to open surgical approach. The operative time and blood loss were presented without following the expected learning curve when they were compared to similar training programs. The systematic education achieved favorable outcome in the trainee group. The original training program to obtain the license in endoscopic surgical skill qualification system (ESSQS) of the JSE started at 2006 at the Department of Urology of Okayama University Hospital. We reviewed the outcomes of laparoscopic adrenalectomy surgeries that were performed by the trainees enrolled in the program. We retrospectively evaluated the case of 76 patients who underwent laparoscopic adrenalectomy by trainees in comparison with 43 cases performed by ESSQS certified urologists from March 2009 to November 2017. The median number of cases performed by 18 trainees (6-11 years after graduation) was 4 (range : 1-9), and by 9 certified urologists was 2 (range : 1-26). There were no significant differences in the patient background between two groups. The operative time was significantly shorter in the certified group (p = 0.0122). There was no case that required blood transfusion nor conversion to open surgical approach. The operative time and blood loss were presented without following the expected learning curve when they were compared to similar training programs. The systematic education achieved favorable outcome in the trainee group. 当院泌尿器科では2006年から独自の腹腔鏡手術教育プログラムを作成し手術教育を行っている. 2009年3月から2017年11月までに当院で腹腔鏡技術認定医トレーニング中の泌尿器科医師が執刀した腹腔鏡下副腎摘除術76症例と, 当院の腹腔鏡技術認定医が行った43症例との周術期成績の比較検討を行った. プログラム対象者は合計18人 (卒後6-11年目) で, 1人あたりの執刀症例数は中央値4例 (range : 1-9), 認定医の術者は9名で中央値2例 (range : 1-26) であった. 患者背景には大きな差は認めなかった. 手術時間は認定医群で有意に短かった (p=0.0122) ものの, 両群において輸血や開腹移行症例, 重篤な合併症はなかった. 手術時間・出血量に急激なラーニングカーブは認めなかった. 系統的な手術教育により腹腔鏡手術経験の未熟な術者の初期症例においても, 安定した周術期成績を残すことが出来た. |
Author | 和田 耕一郎 那須 保友 和田里 章悟 枝村 康平 渡邉 豊彦 佐古 智子 荒木 元朗 小林 泰之 西村 慎吾 定平 卓也 岩田 健宏 高本 篤 |
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References | 2) 田中正利, 桶川隆嗣, 酒井英樹, 他 (2008) 副腎腫瘍に対する腹腔鏡下副腎摘除術. 泌尿器腹腔鏡手術ガイドライン. 日本Endourology・ESWL学会, 東京, pp. 3-14 3) 高橋 聡, 舛森直哉, 北村 寛, 他 (2012) 腹腔鏡下副腎摘除術の検討. 泌紀 58 (7) : 315-318 1) Kanda Y (2013) Investigation of the freely-available easy-to use software “EZR” (Easy R) for medical statistics. Bone Marrow Transplant 48 : 452-458 |
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Title | The importance of systematic operative training in laparoscopic adrenalectomy for novice surgeons |
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