title: Effective stepwise training and procedure standardization for young surgeons to perform laparoscopic left hepatectomy.
abstract: 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.
  
  
  
  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).
  
  
  
  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).
  
  
  
  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.
authors.affiliation: Department of Surgery, University of Tokushima, 3-18-15 Kuramoto-cho, Tokushima City, Tokushima, 770-8503, Japan. yamada.shinichiro@tokushima-u.ac.jp.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Yamada
authors.affiliation: Department of Surgery, University of Tokushima, 3-18-15 Kuramoto-cho, Tokushima City, Tokushima, 770-8503, Japan.
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Shimada
authors.affiliation: Department of Surgery, University of Tokushima, 3-18-15 Kuramoto-cho, Tokushima City, Tokushima, 770-8503, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Imura
authors.affiliation: Department of Surgery, University of Tokushima, 3-18-15 Kuramoto-cho, Tokushima City, Tokushima, 770-8503, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Morine
authors.affiliation: Department of Surgery, University of Tokushima, 3-18-15 Kuramoto-cho, Tokushima City, Tokushima, 770-8503, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ikemoto
authors.affiliation: Department of Surgery, University of Tokushima, 3-18-15 Kuramoto-cho, Tokushima City, Tokushima, 770-8503, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Saito
authors.affiliation: Department of Surgery, University of Tokushima, 3-18-15 Kuramoto-cho, Tokushima City, Tokushima, 770-8503, Japan.
authors.forename: Chie
authors.initials: C
authors.lastname: Takasu
authors.affiliation: Department of Surgery, University of Tokushima, 3-18-15 Kuramoto-cho, Tokushima City, Tokushima, 770-8503, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Yoshikawa
authors.affiliation: Department of Surgery, University of Tokushima, 3-18-15 Kuramoto-cho, Tokushima City, Tokushima, 770-8503, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Teraoku
authors.affiliation: Department of Surgery, University of Tokushima, 3-18-15 Kuramoto-cho, Tokushima City, Tokushima, 770-8503, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Yoshimoto
authors.affiliation: Department of Surgery, University of Tokushima, 3-18-15 Kuramoto-cho, Tokushima City, Tokushima, 770-8503, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takata
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D002568:Certification; D002983:Clinical Competence; D005246:Feedback; D005260:Female; D013502:General Surgery / Q000193:education*; D006498:Hepatectomy / Q000193:education* / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000193:education* / Q000379:methods; D008297:Male; D008611:Mentors; D008875:Middle Aged; D061646:Operative Time; D012015:Reference Standards; D066231:Surgeons
keywords: Education; Feedback; Laparoscopic hepatectomy; Mentor; Simulation; Young surgeon