Utilization of Laparoscopic and Open Inguinal Hernia Repair
BACKGROUND: Laparoscopic inguinal hernia repair is a safe and effective treatment for inguinal hernias, and is considered by some to be the procedure of choice for recurrent inguinal hernias. Little is known, however, about the frequency with which laparoscopic inguinal hernia repair is performed and the determinants of its utilization.METHODS: We performed a retrospective cohort… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Education / Simulation
Surgical Simulation in Africa: The Feasibility and Impact of a Three Day Fls Course
Introduction: Although simulation is now considered important for learning technical skills, there is very little literature assessing the use of simulation in resource restricted countries. The purpose of this study was to determine the feasibility and impact of a three day Fundamentals of Laparoscopic Surgery (FLS) course in Botswana, Africa. Methods: A total of 20… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Education / Simulation
Do Hybrid Simulator-generated Metrics Correlate with Content Valid Outcome Measures?
Objective: Hybrid simulators provide objective metrics for laparoscopic task performance. The aim of this study was to evaluate the correlation between hybrid simulator-generated metrics and content valid outcome measures.Methods and Procedures: Residents underwent training with a previously validated 5-task simulation model (5-TSM). Tasks included: clip/divide vessel, excise lesion, loop appendectomy, mesh placement with tacks, and… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Education / Simulation
Laparoscopic Nissen Fundoplication Assessment: Task Analysis as Model for the Development of a Procedural Checklist
Objective: Learning an advanced laparoscopic procedure is a complex process that requires clinical exposure, direct teaching, and deliberate practice. However, expert laparoscopic surgeons automate their knowledge making it difficult to teach all of the incremental steps. The aim of this study was to deconstruct the operative steps of a laparoscopic Nissen fundoplication (LNF) and develop… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Education / Simulation
A Model for Longitudinal Mentoring and Telementoring of Laparoscopic Colon Surgery
OBJECTIVE: To demonstrate the feasibility of longitudinal mentoring and telementoring of community surgeons in laparoscopic colon surgery.METHODS: A formal mentoring protocol was established between a university centre and surgeons at a local 134 bed community hospital 60km away. The community surgeons (CS) attended a didactic course on laparoscopic colon surgery before attending surgery at the… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Education / Simulation
When Surgery Stops: A Quantitative Video Analysis of Workflow During Laparoscopic Surgery
Introduction: Interruptions in surgical workflow has been shown to lead to OR inefficiencies and patient injury; however, we lack knowledge as to what causes these interruptions and to what degree these interruption affect the procedure time (PT). Workflow is a result of teamwork, thus interruptions were analyzed based on their effect on the teamwork rather… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Education / Simulation
Validation that a one-year fellowship in minimally invasive/bariatric surgery can eliminate the “learning curve” for laparoscopic Roux-en-Y gastric bypass (LRYGB): Fellows’ first 100 cases in practice replicate the quality of their training institution.
INTRODUCTION: The concept that advanced surgical training can reduce or eliminate the “learning curve” for complex procedures makes logical sense but is difficult to verify and has not been tested for LRYGB. We sought to determine if minimally invasive / bariatric surgery fellowship graduates would demonstrate complication-related outcomes (CRO) equivalent to the outcomes achieved during… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Education / Simulation
Intraoperatively-Acquired Objective Measures to Monitor Laparoscopic Skills
Introduction: Standard skill evaluation methods in the operating room (OR) include direct observation and checklists; both are time consuming and subject to bias. Objective assessment systems have been proposed for simulators using dexterity measures. However, motor performance in simulators can differ from that in the OR, so monitoring motor performance in the OR is necessary… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Education / Simulation
Does Access to Minimally Invasive Surgery Account for Racial Differences in Surgical Outcome
Introduction: Minority populations consistently demonstrate poorer medical and surgical outcomes. Given that surgery is a rapidly evolving field, we hypothesized that poorer surgical outcomes by black patients are related to lack of access to minimally invasive surgery (MIS). Methods: We used data from the Nationwide Inpatient Sample, a 20% stratified random sample of patients admitted… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Education / Simulation
No Correlation Between Self-Reported Musical Instrument Experience and Gains in Self-Confidence Levels of Trainees Undergoing Basic Skills Training in Minimally Invasive Surgery
Background: Reduced tactile sensation, two-dimensional depth, and the fulcrum effect make minimally invasive surgery (MIS) a challenge to teach and learn. Although video game experience appears to enhance MIS skills acquisition, the effect of prior experience in other complex motor skills is less clear. We examined if previous experience playing musical instruments contributed to self-confidence… Continue Reading
- Type:
- Posters
- Topic:
- Education / Simulation
Proficiency-based Fls Skills Training Results in Durable Performance Improvement and Uniform Certification Pass Rate
Introduction: We have previously documented a 100% certification pass rate immediately following a proficiency-based skills training curriculum for the Fundamentals of Laparoscopic Surgery (FLS) program. The purpose of this study was to determine the durability of skills acquired after initial training.Methods: Novice medical students (n=21) were enrolled in IRB-approved protocols at 2 institutions. As previously… Continue Reading
- Type:
- Posters
- Topic:
- Education / Simulation
FLS Test is Transferable to ProMIS Simulator
INTRODUCTION: The McGill Inanimate System for Training and Evaluation of Laparoscopic Skills (MISTELS) is comprised of five tasks with an objective scoring system, and has been incorporated by SAGES in their Fundamentals of Laparoscopic Surgery (FLS) program. MISTELS has high inter-rater and test-retest reliability and correlates with operative skill. However, the FLS program is labor… Continue Reading
- Type:
- Posters
- Topic:
- Education / Simulation
Pre-training on Virtual Reality prior to the Fundamentals of Laparoscopic Surgery (FLS): Is it beneficial?
Introduction: We previously reported a proficiency-based Fundamentals of Laparoscopic Surgery (FLS) skils curriculum. We hypothesized that pre-training on virtual reality trainers would decrease the number of trials needed to attain the proficiency levels in this FLS curriculum.Methods: All subject groups followed this general algorithm, FLS pre-testing, proficiency-based training using a virtual reality (VR) trainer, FLS… Continue Reading
- Type:
- Posters
- Topic:
- Education / Simulation
Current Status of Laparospic Education and Training in United States Surgical Residency Programs. Are We Doing Enough?
Background: The amount of laparoscopic training provided to surgical residents varies widely from institution to institution. Consequently, the ability to safely perform complex laparoscopic procedures also likely varies. Nonetheless, graduating residents are expected to perform laparoscopic procedures independently without additional training. The extent to which residents are adequately trained for such procedures is unclear. Methods:… Continue Reading
- Type:
- Posters
- Topic:
- Education / Simulation
Trans-oral technique for gastrojejunostomy in laparoscopic Roux-en-Y gastric bypass can ease learning curve and reduce cost
TRANS ORAL TECHNIQUE FOR GASTROJEJUNOSTOMY IN LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS CAN EASE LEARNING CURVE AND REDUCE COST Background: The stapled gastrojejunostomy of the laparoscopic Roux-en-Y gastric bypass (LRYGB) can be created by linear stapling techniques or by a circular stapler. In the circular stapling technique, the anvil of the stapler can be introduced into the… Continue Reading
- Type:
- Posters
- Topic:
- Education / Simulation