Impact of a Laparoscopic Renal Surgery Mini-Fellowship Program on Postgraduate Urologist Practice Patterns at 3-Year Followup

Kolla, Surendra B.; Gamboa, Aldrin Joseph R.; Li, Roger; Santos, Rosanne; Gan, Jennifer; Shell, Cynthia; Andrade, Lorena A.; Louie, Michael K.; Clayman, Ralph V.; McDougall, Elspeth M.

doi:10.1016/j.juro.2010.06.097

Cited by 22 publications

(17 citation statements)

References 10 publications

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“…Concomitantly, participants performed hand-assisted laparoscopic surgery considerably less often ( P = 0.008)[40]. In a large sample including 106 urologists, Kolla et al[41] reported similar findings to those described before. In a study evaluating the impact of 5-d mini fellowship program that included tutorial sessions, hands-on inanimate and animate skills training, and clinical case observations, there was also a significant increase in the laparoscopic procedures performed by the participants after the program.…”

Section: Impact Of Laparoscopic Training Coursesmentioning

confidence: 56%

Impact of laparoscopic surgery training laboratory on surgeon's performance

Torricelli¹,

Barbosa²,

Marchini³

2016

WJGS

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Minimally invasive surgery has been replacing the open standard technique in several procedures. Similar or even better postoperative outcomes have been described in laparoscopic or robot-assisted procedures when compared to open surgery. Moreover, minimally invasive surgery has been providing less postoperative pain, shorter hospitalization, and thus a faster return to daily activities. However, the learning curve required to obtain laparoscopic expertise has been a barrier in laparoscopic spreading. Laparoscopic surgery training laboratory has been developed to aid surgeons to overcome the challenging learning curve. It may include tutorials, inanimate model skills training (box models and virtual reality simulators), animal laboratory, and operating room observation. Several different laparoscopic courses are available with specific characteristics and goals. Herein, we aim to describe the activities performed in a dry and animal-model training laboratory and to evaluate the impact of different kinds of laparoscopic surgery training courses on surgeon’s performance. Several tasks are performed in dry and animal laboratory to reproduce a real surgery. A short period of training can improve laparoscopic surgical skills, although most of times it is not enough to confer laparoscopic expertise for participants. Nevertheless, this short period of training is able to increase the laparoscopic practice of surgeons in their communities. Full laparoscopic training in medical residence or fellowship programs is the best way of stimulating laparoscopic dissemination.

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Section: Impact Of Laparoscopic Training Coursesmentioning

confidence: 56%

Impact of laparoscopic surgery training laboratory on surgeon's performance

Torricelli¹,

Barbosa²,

Marchini³

2016

WJGS

View full text Add to dashboard Cite

show abstract

“…37 This concern has been recognized by both the urology and surgery communities, and, in recent years, several mentored and simulator-based programs have been developed to facilitate and enhance training in laparoscopy. 38,39 Nonetheless, despite the existence of recommended paradigms for laparoscopic training and credentialing since the early 1990s, training in laparoscopy still relies heavily on preceptorship and self-regulation rather than any formal certification process while credentialing varies by hospitals and generally involves limited regulatory oversight. [40][41][42] Similar challenges are now being recognized during the adoption of the robotic platform in surgical oncology.…”

Section: Discussionmentioning

confidence: 99%

“…43 More vigorous training has been shown to expedite the learning process, transfer technical skill at a higher rate, and lead to higher retention over the longterm. 39,[44][45][46] To promote the advancement of patient care through new surgical technologies while also ensuring patient safety, the American College of Surgeons has established multiple Accredited Education Institutes to facilitate transfer of surgical innovation to practicing surgeons, [47][48][49] similar programs may be beneficial for urologists and other surgical oncologists who are faced with the challenge of adopting complex new technologies.…”

Section: Discussionmentioning

confidence: 99%

Population‐level comparative effectiveness of laparoscopic versus open radical nephrectomy for patients with kidney cancer

Tan

Wolf

et al. 2011

Cancer

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BACKGROUND:Because there is limited population-based evidence supporting the comparative effectiveness of laparoscopic radical nephrectomy (LRN) after its widespread adoption, we compared trends in hospital-based outcomes among patients with kidney cancer treated with LRN or open radical nephrectomy (ORN). METHODS: Using linked SEER-Medicare data, the authors identified patients with kidney cancer who were treated with LRN or ORN from 2000 through 2005. The authors measured 4 primary outcomes: intensive care unit (ICU) admission, prolonged length of stay, 30-day hospital readmission, and in-hospital mortality. The authors then estimated the association between surgical approach and each outcome, adjusting for patient demographics, tumor characteristics, and year of surgery. RESULTS: The authors identified 2108 (26%) and 5895 (74%) patients treated with LRN and ORN, respectively. Patients treated with LRN were more likely to be white, female, of higher socioeconomic position, and to have tumor sizes of 4 cm (all P < .05). The adjusted probability of ICU admission and prolonged length of stay was 41% and 46% lower, respectively, for patients undergoing LRN (P < .001). Although uncommon for both groups, the adjusted probability of in-hospital mortality was 51% higher (2.3% vs 1.5%, P ¼ .04) for patients treated with a laparoscopic approach. CONCLUSIONS: At a population level, patients treated with LRN have a lower likelihood of ICU admission and prolonged length of stay, supporting the convalescence benefits of laparoscopy. In-hospital mortality, however, was higher among patients treated with LRN. The latter finding suggests a potentially unanticipated consequence of this technique and highlights the need for long-term monitoring during and after the widespread adoption of new surgical technologies. Cancer 2011;117:4184-93.

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“…Five-day minifellowship/miniresidency courses have been proven to provide urologic surgeons with an effective introduction and uptake of laparoscopic urology. 12 The Japanese Society of Endourology and ESWL have established the Endoscopic Surgical Skill Qualification System in urologic laparoscopy. 13 In the Japanese model, the mentees must have completed 2 years of laparoscopic training, performed 20 laparoscopic procedures, and are then independently assessed by two expert referees who view unedited videotapes showing the entire laparoscopic procedure.…”

Section: Discussionmentioning

confidence: 99%

Description and Validation of a Modular Training System for Laparoscopic Nephrectomy

Stewart

Phipps

Little

et al. 2012

Journal of Endourology

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Mentees matched the median British Association for Urological Surgeons (BAUS) registry operative time (LN, 120-180 min, LNU, 180-240 min) and had lower conversion rates (2.9% vs 6.4% for BAUS). Mentees matched median BAUS database reported blood loss (LN and LNU <500 mL) and length of stay (LN-4 days, LNU-5 days). This modular training program allows urologists to become independent in LN after a short period of focused training in the training center followed by a short period of mentoring in the mentee's own center.

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Impact of a Laparoscopic Renal Surgery Mini-Fellowship Program on Postgraduate Urologist Practice Patterns at 3-Year Followup

Abstract: An intensive 5-day laparoscopic ablative and reconstructive renal surgery course enabled postgraduate urologists to effectively introduce and expand the volume and breadth of their laparoscopic renal surgery practice.

Cited by 22 publications

References 10 publications

Impact of laparoscopic surgery training laboratory on surgeon's performance

Impact of laparoscopic surgery training laboratory on surgeon's performance

Population‐level comparative effectiveness of laparoscopic versus open radical nephrectomy for patients with kidney cancer

Description and Validation of a Modular Training System for Laparoscopic Nephrectomy

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