Laparoscopic Surgery A Standard in Some Basic Procedures
Since its introduction, laparoscopic surgery accepts and established as the gold standard in the training program of surgical residents. And laparoscopic cholecystectomy is the most performed procedure in different hospitals worldwide. However, not all hospitals have the necessary equipment to perform it, much less to teach it. Ethicon Laparoscopic Trainer.
Laparoscopic Training simulation with Ethicon Laparoscopic Trainer is a factual choice.
First Laparoscopic Cholecystectomy
In 1990, performs the first laparoscopic cholecystectomy, since then the training of the Surgery resident has required constant renewal in the academic programs. Which has required qualified and trained tutors in the different laparoscopic procedures.
Laparoscopic surgery also requires continuous updating and therefore the acquisition of technological advances. Since advances in technological instruments currently classifies into 3 categories:
- Facilitation,
- Training and
- Complementary
There are different teaching programs for general surgery, with different durations: in some 4 years and in others up to 5. During which goals are set for surgical procedures assisted and performed by residents, with supervision of tutors and physicians attached to the program. Laparoscopic surgery cannot follow the old learning model. I see it, I do it and I teach it, traditional training has evolved by initiating surgical procedures in virtual simulators. Thus, giving budding surgeons optimal training.
Natural Settings for Laparoscopic Surgical Training
The natural setting for surgical training continues to be the residency in general surgery. However, in many residencies in Latin America there is no systematic use of laparoscopy, even in others. These procedures perform by surgeons who are still in training in this field. surgical approach and in some, although there is a program for residents, the level with which they finish is only basic laparoscopic surgery. Ethicon Laparoscopic Trainer.
Different Surgical Techniques
There are for basic laparoscopic procedures where the position of the surgeon varies, for example the position to the right of the patient or the position where the surgeon stands between the patient’s legs, so that the use of both hands for the surgeon and fewer assistants make the development of the surgery easier.
Safety Criteria
On the other hand, safety criteria or steps implements for the success and well-being of the patient, which has shown that the laparoscopic surgical technique performed with these canons has results with lower morbidity and mortality compared to institutions that do not follow these standards.
Training Of Surgical Residents
With the advent of technology, specialization courses and improvement in the different health programs, a new question arises. Is the training of surgical residents currently adequate and effective? For minimally invasive surgery technique, many of them have not received practical training with trainers similar to Ethicon Laparoscopic Trainer.
Academic Program for General Surgery Residents
Laparoscopic surgery at the began in 1991 and currently establishes in then with basic laparoscopic simulator training and directed development and tutorial on patients.
The objective of this study is to assess whether the training received for 4 years is safe and sufficient, by identifying the most common surgical complications in a basic laparoscopy center for residents.
Prospective, Descriptive, Observational Study
It is a prospective, descriptive, observational, and cross-sectional study in patients operated by basic laparoscopic surgery in the period from January 2008 to October 2011. With a total of 1,104 cases that met the inclusion criteria, which were to be patients operated by the same Rotating surgeon and general surgery residents in the Medical Specialties Unit (UNEME) and who had complete records, according to the data collection sheet, and had understood and signed an informed consent for surgery and participation in this study.
Variables Of Study
Variables of gender, age, comorbidities, type of surgery, technique (1 or 2 hands), previous abdominal surgery, performing surgeon (resident or primary physician), surgical time, conversion to open surgery, complications, hospital stay, mortality collected.
Basic laparoscopic surgery considers to be cholecystectomy, tubal occlusion, resection or drainage of ovarian cysts, diagnostic laparoscopy and biopsy taking.
Handling The Laparoscopy Equipment
In all surgeries, the surgical team forms by a general surgeon in the role of tutor. Who was responsible for all the patients included in this study, 1 or 2 residents? An anesthesiologist, a surgical nurse and a circulating, support of a technician for handling the laparoscopy equipment.
The discharge of the patients assesses according to their evolution established in a safe outpatient surgery evaluation system. Where previous studies in this unit mentions, this at 8 or 12 hours after surgery and with an adequate recovery. Those who presented nausea, vomiting, pain, or bleeding required a hospital stay of more than 24 hours.
Criteria For Postoperative Follow-Up
Postoperative follow-up performs by the senior resident, who removed the drain at 48h, removed the stitches and consulted at 7 days. And checked the patient at 15 and 30 days for discharge. The information of the patients collects in a data entry sheet. Which integrates into a database in a spreadsheet made in the Excel program.
Designed specifically for this study, to carry out the statistical analysis, and performed descriptive statistics of central tendency. As it was an observational study without a control group, no values for statistical significance obtains. Ethicon Laparoscopic Trainer.
Conclusion:
Handed technique Cholecystectomy are safe and for both the surgeon and Assistant not very high learning curve. This seen at the end of his 4 years of training the residents of this hospital. Study to grow with the skill and knowledge necessary for basic laparoscopic surgery.
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