Preceptorship and Proctorship as an Effective Way to Learn Laparoscopic Sleeve Gastrectomy

Garneau, Philippe; Ahmad, Khaled S; Carignan, Sébastien; Trudeau, Patrick

doi:10.1007/s11695-014-1343-6

Cited by 13 publications

(11 citation statements)

References 9 publications

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“…The concept of proctored preceptorship has been demonstrated to be useful in literature, specially in minimal access and robotic surgery 31–33. In a study, Clermont et al34 have shown that standardized institutional operative protocol together with proficient proctorship, contribute to a shorter learning curve with fewer cases required to reach proficiency for TAMIS for local excision of rectal neoplasm.…”

Section: Discussionmentioning

confidence: 99%

Use of Critical View of Safety and Proctored Preceptorship in Preventing Bile Duct Injury During Laparoscopic Cholecystectomy—Experience of 3726 Cases From a Tertiary Care Teaching Institute

Bansal¹,

Krishna²,

Jain³

et al. 2022

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Introduction: Bile duct injury (BDI) continues to occur despite technological advances and improvements in surgical training over the past 2 decades. This study was conducted to audit our data on laparoscopic cholecystectomies performed over the past 2 decades to determine the role of Critical View of Safety (CVS) and proctored preceptorship in preventing BDI and postoperative complications. Materials and Methods: All patients undergoing elective laparoscopic cholecystectomy were analyzed retrospectively. The data were obtained from a prospectively maintained database from January 2004 to December 2019. Proctored preceptorship was used in all cases. Intraoperative details included the number of patients where CVS was defined, number of BDI and conversions. Postoperative outcomes, including hospital stay, morbidity, and bile duct stricture, were noted. Results: Three thousand seven hundred twenty-six patients were included in the final analysis. Trainee surgeons performed 31.6% of surgeries and 9.5% of these surgeries were taken over by the senior surgeon. A CVS could be delineated in 96.6% of patients. The major BDI rate was only 0.05%. Conclusion: This study reiterates the fact that following the basic tenets of safe laparoscopic cholecystectomy, defining and confirming CVS, and following proctored preceptorship are critical in preventing major BDI.

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Section: Discussionmentioning

confidence: 99%

Use of Critical View of Safety and Proctored Preceptorship in Preventing Bile Duct Injury During Laparoscopic Cholecystectomy—Experience of 3726 Cases From a Tertiary Care Teaching Institute

Bansal¹,

Krishna²,

Jain³

et al. 2022

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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“…(41,(55)(56)(57) Our learner-centred model also incorporated the spirit of newer models of surgical training based on task deconstruction, detailed steps and identifi cation of potential errors, which represents a superior system of training to traditional apprenticeship, and to which low complication rates and initial success have been attributed. (58,59) Our model allowed the team to focus on rapid service provision while simultaneously acquiring technical capability and benefitting from instant feedback from the proctor, and the team training together allowed us to adopt a singular practice tailored to suit our hospital's infrastructure.…”

Section: Discussionmentioning

confidence: 99%

Rapid initiation of fetal therapy services with a system of learner-centred training under proctorship: the National University Hospital (Singapore) experience

Gosavi

Vijayakumar

et al. 2017

smedj

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INTRODUCTION Management of complicated monochorionic twins and certain intrauterine structural anomalies is a pressing challenge in communities that still lack advanced fetal therapy. We describe our efforts to rapidly initiate selective feticide using radiofrequency ablation (RFA) and selective fetoscopic laser photocoagulation (SFLP) for twin-to-twin transfusion syndrome (TTTS), and present the latter as a potential model for aspiring fetal therapy units. METHODSFive pregnancies with fetal complications were identifi ed for RFA. Three pregnancies with Stage II TTTS were selected for SFLP. While RFA techniques utilising ultrasonography skills were quickly mastered, SFLP required stepwise technical learning with an overseas-based proctor, who provided real-time hands-off supervision.RESULTS All co-twins were live-born following selective feticide; one singleton pregnancy was lost. Fetoscopy techniques were learned in a stepwise manner and procedures were performed by a novice team of surgeons under proctorship. Dichorionisation was completed in only one patient. Five of six twins were live-born near term. One pregnancy developed twin anaemia-polycythaemia sequence, while another was complicated by co-twin demise.DISCUSSION Proctor-supervised directed learning facilitated the rapid provision of basic fetal therapy services by our unit. While traditional apprenticeship is important for building individual expertise, this system is complementary and may benefi t other small units committed to providing these services.

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“…Successful completion of 25 laparoscopic cases proctored by a surgeon credentialled for laparoscopic bariatric surgery. 15 …”

Section: Definition and Suggested Training For Bariatric Surgeonsmentioning

confidence: 99%

“…• Successful completion of 25 laparoscopic cases proctored by a surgeon credentialled for laparoscopic bariatric surgery. 15 • Review of the surgeon's first 5 independent cases by a designated committee, including the institution's chief of surgery.…”

Section: Surgeonsmentioning

confidence: 99%

Guidelines for Canadian bariatric surgical and medical centres: a statement from the Canadian Association of Bariatric Physicians and Surgeons

Garneau

Glazer

Jackson

et al. 2022

cjs

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Summary The goal of this statement is to offer standardization in bariatric care across Canada, to provide patients with optimal access to obesity treatment and potentially improve outcomes by reducing complications, length of hospital stay and readmission rate. The definition of Canadian standards also aims to promote a comprehensive, multidisciplinary approach to patients with obesity, to define the minimal qualifications for surgical and medical training and to offer credentialling for bariatric surgical and medical centres. In addition, we emphasize the importance of developing a national registry for the assessment of quality of care across the country and to evaluate outcomes of long-term treatment. These recommendations are based on expert opinion as well as the most recent clinical evidence.

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Preceptorship and Proctorship as an Effective Way to Learn Laparoscopic Sleeve Gastrectomy

Abstract: This study showed the effectiveness of training provided through preceptorship/proctorship with a specialized consulting surgeon. The low complication rate and the weight loss achieved in only 6 months demonstrate the safety and efficacy of this learning method.

Cited by 13 publications

References 9 publications

Use of Critical View of Safety and Proctored Preceptorship in Preventing Bile Duct Injury During Laparoscopic Cholecystectomy—Experience of 3726 Cases From a Tertiary Care Teaching Institute

Use of Critical View of Safety and Proctored Preceptorship in Preventing Bile Duct Injury During Laparoscopic Cholecystectomy—Experience of 3726 Cases From a Tertiary Care Teaching Institute

Rapid initiation of fetal therapy services with a system of learner-centred training under proctorship: the National University Hospital (Singapore) experience

Guidelines for Canadian bariatric surgical and medical centres: a statement from the Canadian Association of Bariatric Physicians and Surgeons

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