Training potential in minimally invasive surgery in a tertiary care, paediatric urology centre

Schroeder, Rogier P. J.; Chrzan, Rafał; Klijn, Aart J.; Kuijper, Caroline F.; Dik, Pieter; Jong, Tom P.V.M. de

doi:10.1016/j.jpurol.2015.03.022

Cited by 4 publications

(9 citation statements)

References 24 publications

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“…Numerous centers struggle with insufficient case volumes to adequately train their staff. 41 In an effort to increase exposure to pediatric MIS and offer adequate training to surgeons, centralization should be encouraged to ensure that centers are able to provide optimal care for patients as higher case numbers per center increase the probability that surgery is performed at the tail of the learning curve. In addition, collaboration with other specialties or inviting expert surgeons to assist during the learning period could improve clinical outcomes.…”

Section: Trainees 31 Consultants 12mentioning

confidence: 99%

Minimally Invasive Pediatric Surgery: The Learning Curve

et al. 2020

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The use of minimally invasive surgery (MIS) in pediatric patients has increased over the past decades. The process of mastering a new procedure is termed the learning curve, during which the ability to operate increases but poorer outcomes are produced. We aim to analyze the current evidence on learning curves in pediatric MIS and evaluate its impact on patient's clinical outcomes. A systematic literature search was performed for studies listed on PubMed that reported on the learning curve for MIS surgical procedures. Studies were included if they stated the number of procedures required to reach a consistency in outcomes or if they compared outcomes between early and late period of MIS experience regarding the endpoints operative time, conversions, and intra-/postoperative complications. A total of 22 articles reporting on 11 surgical procedures were included in the study. Most authors reported a significant decrease in operative time as well as peri- and postoperative complications with increasing experience of the surgeon. Complications ranged from minor to major, the latter being especially severe for patients receiving pyloromyotomy (5–7% higher risk of mucosal perforation), esophageal atresia repair (15% higher leakage rate and 19–77% higher stenosis rate), or Kasai portoenterostomy (26–35% more liver transplants in the first year after surgery) during the learning curve period. Pediatric MIS comes with a considerable learning curve that may have a significant impact on the patient's clinical outcomes. Efforts should be made to minimize the effect of the learning curve on the patients.

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Section: Trainees 31 Consultants 12mentioning

confidence: 99%

Minimally Invasive Pediatric Surgery: The Learning Curve

et al. 2020

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“…A total of 26 studies of adolescent (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27) and pediatric surgery (28)(29)(30)(31)(32)(33). Huge variation was noticed in the types of validity sought by researchers and suboptimal incorporation of these tools into curricula was noted across the subgroups of urological surgery.…”

Section: Resultsmentioning

confidence: 99%

“…However, only 6 out of the 26 selected studies were focused on pediatric surgery (28)(29)(30)(31)(32)(33).…”

Section: Resultsmentioning

confidence: 99%

“…Over the years, MIS has evolved due to improvements in the instrumentation and the creativity of specialized surgeons. Simple diagnostic and ablative procedures have payed the way for intricate, reconstructive, laparoscopic surgery (32).…”

Section: Discussionmentioning

confidence: 99%

“…The BAUS indicated the aim to do at least 12 marker cases per year (11). For intricate reconstructive MIS (such as laparoscopic pyeloplasty) approximately 30 procedures are proposed as necessary to develop proficiency (32).…”

Section: Criteria For Training Program In Pediatric Laparoscopic Urolmentioning

confidence: 99%

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Training for MIS in pediatric urology: proposition of a structured training curriculum

et al. 2017

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In Europe there are a lot of training centers for minimally invasive surgery (MIS) but a standardized MIS training program in pediatric urology doesn't exist at the moment. We performed a literature review with the last goals to propose a structured training curriculum in MIS urology for pediatric surgeons. Pediatric urologists have to obtain a valid MIS training curriculum completing the following 4 steps: (I) Theoretical part (theoretical courses, masterclass) to acquire theoretical knowledge; (II) experimental training (simulation on pelvic trainer, virtual reality simulators, animal models, 3-D models) to acquire basic laparoscopic skills; (III) stages in European centers of reference for pediatric MIS urology to learn all surgery aspects; (IV) personal operative experience. At the end of the training period, the trainee would be expected to perform several MIS urological procedures independently, under supervision of an expert tutor. At the end of the training program, each center will analyze the candidate training booklet and release for each applicant a certification after an exam. We think that this MIS training program in pediatric urology may assure an integrated acquisition of basic and advanced laparoscopic skills during residency training in pediatric urology. Each European country should adopt this program so as to secure a standardized technical qualification in MIS urology for all future pediatric urologists.

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