Impact of education with authorized technical experts on colorectal laparoscopic skills.
OBJECTIVE
Laparoscopic skills training is becoming the standard for educating surgical residents. Because of the specific procedure which differs from that of open surgery, it is imperative to establish a unique training system to promote efficiency of learning laparoscopic skills. The aim of this study was to evaluate the efficiency of learning laparoscopic skills with or without authorized experts of JSES.


METHODS
Among 71 patients who underwent laparoscopic colectomy from 2004 to 2009, 30 patients who underwent operation in introduction era without a technical expert (2004-2006), 17 patients who underwent operation in late period of introduction era without a technical expert (2006-2008), 12 patients who underwent operation by resident with technical expert (2008-2009) and 12 patients who underwent operation by technical expert, were investigated. Operative time, amount of blood loss, intra- and post-operative complications and conversion to open surgery were investigated.


RESULTS
Operative time: 477:333:262:220 minutes (early period:late period:resident:expert), amount of blood loss: 494:73:21:20mL and complications: ileus: 0:1:0:0, leakage: 1:1:3:0, neurological disturbance: 2:1:0:0.


CONCLUSIONS
Instruction by authorized technical experts of JSES is helpful to avoid pitfalls which are not seen in open surgery without an expert.
Department of Surgery, The University of Tokushima, Tokushima, Japan. takassan@clin.med.tokushima-u.ac.jp
Takashi
T
Iwata
Nobuhiro
N
Kurita
Masanori
M
Nishioka
Shinya
S
Morimoto
Kozo
K
Yoshikawa
Jun
J
Higashijima
Toshihiro
T
Nakao
Masato
M
Komatsu
Mitsuo
M
Shimada
D000704:Analysis of Variance; D057868:Anastomotic Leak / Q000209:etiology; D016063:Blood Loss, Surgical; D016009:Chi-Square Distribution; D003082:Colectomy / Q000009:adverse effects / Q000193:education* / Q000592:standards; D015179:Colorectal Neoplasms / Q000601:surgery*; D004503:Education, Medical, Graduate / Q000379:methods*; D006801:Humans; D045823:Ileus / Q000209:etiology; D007396:Internship and Residency / Q000379:methods*; D007564:Japan; D010535:Laparoscopy / Q000009:adverse effects / Q000193:education* / Q000592:standards; D013997:Time Factors; D001750:Urinary Bladder, Neurogenic / Q000209:etiology