Effective stepwise training and procedure standardization for young surgeons to perform laparoscopic left hepatectomy

Surg Endosc. 2017 Jun;31(6):2623-2629. doi: 10.1007/s00464-016-5273-3. Epub 2016 Dec 7.

Abstract

Background: Laparoscopic hepatectomy remains one of the most difficult procedures for young surgeons to perform. We recently developed a new training method and standardization procedure for teaching young surgeons to perform laparoscopic left hepatectomy (Lap-LHx). The aim of this study was to assess the effectiveness of our method.

Methods: In 2004, we standardized a laparoscopic procedure for Lap-LHx, using a laparoscopy-assisted method as a stepping stone. The laparoscopic training method comprised the following three steps: (1) training in fundamental procedures using a dry box and checking by mentors; (2) detailed preoperative simulation using Vincent three-dimensional software for each patient; and (3) self-assessment including understanding of relevant anatomy and completion grade for each procedure using a check sheet and feedback by both mentors and a professor. Twenty-three Lap-LHx procedures performed during the study period were divided into two groups: those performed by young non-board-certified surgeons (n = 9) and those performed by senior board-certified surgeons (n = 14).

Results: The blood loss and operative time were similar in the young surgeon (194 g and 336 min, respectively) and senior surgeon groups (208 g and 322 min, respectively).

Conclusion: Our standardized Lap-LHx procedure and stepwise training to perform it enable young surgeons to perform Lap-LHx as confidently and safely as more experienced surgeons.

Keywords: Education; Feedback; Laparoscopic hepatectomy; Mentor; Simulation; Young surgeon.

MeSH terms

  • Aged
  • Blood Loss, Surgical
  • Certification
  • Clinical Competence
  • Feedback
  • Female
  • General Surgery / education*
  • Hepatectomy / education*
  • Hepatectomy / methods
  • Humans
  • Laparoscopy / education*
  • Laparoscopy / methods
  • Male
  • Mentors
  • Middle Aged
  • Operative Time
  • Reference Standards
  • Surgeons