Assessment of laparoscopic skills of Gynecology and Obstetrics residents after a training program

Fernandes, Carla Ferreira Kikuchi; Ruano, José M.; Kati, Léa Mina; Noguti, Alberto Sinhiti; Girão, Manoel Joâo Batista Castello; Sartori, Marair Grácio Ferreira

doi:10.1590/s1679-45082016ao3752

Cited by 16 publications

(24 citation statements)

References 19 publications

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“…It is estimated that 73% of programs lead off laparoscopic skills in North America but only 29% of residencies provide a structured surgical curriculum and only 55% of residency programs have facilities for training in laparoscopy in the United States 26 , 31 , 32 . Moreover, a recent study on accredited North American Obstetrics and Gynecology residency programs revealed that more than 40% were dissatisfied with their current laparoscopy training 33 .…”

Section: Discussionmentioning

confidence: 99%

“…As a matter of fact, despite residency programs are trying to incorporate simulation into the resident training curriculum to supplement the hands-on experience gained in the operating room, this simulation laboratories continue to be under utilized by surgical trainees 29 . In most countries, including Latin America, there is not even teaching models for laparoscopic skills or validated tools for its evaluation during residency 32 .…”

Section: Discussionmentioning

confidence: 99%

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The role of laparoscopy in the propaedeutics of gynecological diagnosis

et al. 2019

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Purpose To evaluate agreement between pre- and post-laparoscopy gynecological diagnosis in order to demonstrate the rationality of this minimally invasive technique use in gynecological propaedeutics. Methods Retrospective chart review study conducted between March 2010 and October 2016 based on a convenience sample. 315 patients undergoing surgical laparoscopy at the Center of Gynecologic Endoscopy and Family Planning of Botucatu Medical School/UNESP. Pre- and postoperative diagnoses were compared by the diagnosis agreement test considering the proportions of events. Results Laparoscopy contributed to diagnosis in 59.6% of infertility cases (P>0.05), in 93.7% of chronic pelvic pain of undetermined origin (P<0.01) and conclusively elucidated the diagnosis of acute abdomen and the ruling out of tubo-ovarian abcess (P<0.05). Laparoscopy also increased the diagnosis of pelvic-abdominal adhesions in 76.7% (P>0.05). Conclusion The use of laparoscopy considerably contributed to diagnostic elucidation, especially in cases of undetermined chronic pelvic pain.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The role of laparoscopy in the propaedeutics of gynecological diagnosis

et al. 2019

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“…8 A Brazilian study conducted by the Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM, in the Portuguese acronym), also demonstrated significant improvement in the competence in students sense of competence to perform level 1 surgeries (diagnostic LP and tubal ligation) and level 2 surgeries (ovarian biopsy, lysis of adhesions, oophorectomy and ectopic pregnancy) after attending a practical course, with an unanimous training approval. 16 A strength of our study is that this training is inserted as a counterpoint to Brazilian reality, as the country experiences contrasts in medical education, so that in one hand, few large universities are able to invest sources in training to qualify their students, 15 while in the other hand, others deal with lack of adequate institutional structure and low quality technology, due to low funds. 1 Following this scenario, it is erroneously believed that only high-tech and high-cost courses would be suitable for learning.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a Laparoscopic Multi-approach Training for Obstetrics and Gynecology Residents

Maranhao

Barison

Alvarenga‐Bezerra

et al. 2020

Rev Bras Ginecol Obstet

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Objective To analyze the applicability and efficiency of a multi-approach laparoscopic training in improving basic laparoscopic skills of obstetrics and gynecology (OBGYN) residents. Methods Cross-sectional, observational and descriptive study, developed at the Experimentation and Surgery Training Center (CETEC, in the Portuguese acronym) of the Hospital Israelita Albert Einstein with OBGYN residents. Theoretical and practical tests were applied to 24 OBGYN residents to assess their laparoscopic skills before and after their participation in an 8-week course. The course involved theoretical lectures and practical laparoscopic surgery exercises developed using rubber models, black boxes, virtual simulators and animal models (pigs). Results There was an overall improvement in the ability of the residents, with an increase in the number of correct answers in the theoretical evaluation and decrease in the time needed to perform practical tests (needle holder assembly and laparoscopic node). The course was evaluated by the students as highly relevant for both improving their surgical skills and motivating them to continue practicing. Conclusion Laparoscopic training using multiple approaches resulted in significant improvement of surgical skills with a high satisfaction level of the participants. Further studies are still needed to measure the long-term retention of these acquired skills.

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“…Moreover, education of the operator is necessary in the context of human resource development. In addition to training tools, such as dry box training and live animals, human cadavers were recently introduced in laparoscopic training (1)(2)(3)(4)(5)(6)(7). Due to the anatomy and tissue fidelity, human cadaver models appear to be optimal for surgical procedure training (8), and the validity of laparoscopic training using fresh-frozen cadavers has been previously reported (7).…”

Section: Discussionmentioning

confidence: 99%

Assessment of laparoscopic training for gynecological malignancies using Thiel‑embalmed human cadavers

et al. 2018

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The introduction of laparoscopic surgery has also been beneficial for patients with gynecological malignancies. In this respect, surgeons should receive related training in the context of human resource development. Hands-on training was introduced using Thiel-embalmed human cadavers (THCs) in 2014. To determine the usefulness of THCs, they were evaluated in terms of tissue color, consistency and operative tactility, among others, compared with in vivo laparoscopic training for gynecological malignancies. Hands-on training sessions using THCs were held for a total of 11 times at Ehime University Graduate School of Medicine between March 2014 and October 2017. Training on THCs included advanced laparoscopic procedures for radical hysterectomy type III. At the end of each training session, data were collected using a standardized, anonymous questionnaire termed the Likert scale. THCs ensured flexibility and plasticity of tissues and organs; therefore, the working space was similar to that in the living body under pneumoperitoneum. After analyzing the quality and consistency of tissue and organ color compared with in vivo conditions, most of the participants agreed or strongly agreed regarding the uterus, adnexa and ureter, but not regarding the large blood vessels. The highest scores were observed in the authenticity of the anatomical condition of each organ. Most participants strongly agreed that training using THCs would help improve their laparoscopic skills with a high level of satisfaction. Furthermore, most participants reported that they would recommend this training to other obstetrician-gynecologists. Laparoscopic training for gynecological malignancies using THCs was comparable to the in vivo conditions in terms of surgical view and operative tactility. Therefore, THCs may be an excellent training tool for improving laparoscopic surgical skills for gynecological malignancies.

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Assessment of laparoscopic skills of Gynecology and Obstetrics residents after a training program

Cited by 16 publications

References 19 publications

The role of laparoscopy in the propaedeutics of gynecological diagnosis

The role of laparoscopy in the propaedeutics of gynecological diagnosis

Evaluation of a Laparoscopic Multi-approach Training for Obstetrics and Gynecology Residents

Assessment of laparoscopic training for gynecological malignancies using Thiel‑embalmed human cadavers

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