[Surgical resident training program in minimally invasive surgery experimental laboratory (CENDOS)].
BACKGROUND
The rapid development of laparoscopic surgery makes resident training programmes necessary.


OBJECTIVE
To analyse the results of a structured programme of laparoscopic training in an experimental laboratory.


METHODS
From 2003 until 2007, we trained 11 general surgery residents for 20 h every 3 months, for three years. The practice consisted of suture and anastomosis in Endo-Trainer with animal organs, as well as laparoscopic techniques in live animals. In the Endo-Trainer practice we evaluated the time and quality of anastomosis performance. In laparoscopic techniques (cholecystectomy and anti-reflux surgery) a task table was evaluated, from 0 (no errors) to 100 (severe lesion).


RESULTS
In total, 314 anastomosis were performed by the 11 residents, with a median of 28.5 per resident (24-42). The mean time for the first gastro-jejunal anastomosis was 135 min (100-140) and 65 min (57.5-105) for the first jejunal-jejunal anastomosis. Maximum learning was achieved after 45 training hours. There were no appreciable differences between both types of anastomosis. There was inadequate anastomosis quality due to leakage in 17.1% during the learning period and 13.7% during the consolidation period. In the animal, 172 procedures were performed. In cholecystectomy and anti-reflux surgery the mean scores were 2.4 and 5.6 points, respectively. In the remaining procedures, subjectively evaluated by the monitors, the quality was adequate in 65%, deficient in 22% and highly deficient in 13%.


CONCLUSIONS
This structured programme of laparoscopic skills based on intestinal anastomosis allows for quicker resident training.
Manuel-Palazuelos
José Carlos
JC
Hospital Universitario Valdecilla, Santander, Cantabria, España. jcmanuel@humv.es
Alonso-Martín
Joaquín
J
Rodríguez-Sanjuan
Juan Carlos
JC
Fernández Díaz
María José
MJ
Gutiérrez Cabezas
José Manuel
JM
Revuelta-Alvarez
Santiago
S
Morales-García
Dieter José
DJ
Herrera Noreña
Luis
L
Gómez-Fleitas
Manuel
M
D000714:Anastomosis, Surgical / Q000193:education*; D000818:Animals; D004724:Endoscopy / Q000193:education*; D007396:Internship and Residency; D010535:Laparoscopy; D019060:Minimally Invasive Surgical Procedures / Q000193:education*; D011446:Prospective Studies; D013536:Suture Techniques / Q000193:education*