Shinichiro Yokoyama, MD1, Yusuke Watanabe, MD1, Yo Kurasima, MD, PhD1, Saseem Poudel, MD2, Yoshinori Suzuki, MD, PhD3, Yuichi Nishihara, MD4, Tomoko Mizota, MD1, Fumitaka Nakamura, MD, PhD5, Toshiaki Shichinohe, MD, PhD1, Satoshi Hirano, MD, PhD1. 1Department of Gastroenterological surgery II, Hokkaido University Graduate School of Medicine, 2Department of Surgery, Steel Memorial Muroran Hospital, 3Department of Surgery, Tonan Hospital, 4Department of Surgery, Tokyo Medical Center, 5Department of Surgery, Teine Keijinkai Hospital
INTRODUTION: Despite the widespread use of laparoscopic surgery in Japan, there is no formal educational curriculum to teach fundamental knowledge of laparoscopic surgery. In order to develop and promote an educational program, it is important to understand the knowledge levels of surgeons and surgical trainees regarding safe laparoscopic surgery. The purpose of this study was to determine baseline knowledge of surgeons and surgical trainees on laparoscopic surgery in Japan.
METHODS: Participants completed 24 multiple-choice questions, testing basic cognitive knowledge of laparoscopic surgery, and a questionnaire regarding the current status of laparoscopic education. The examination was developed according to the 11 content domains of the Fundamentals of Laparoscopic Surgery (FLS) program. Sections of the examination included: “equipment and energy sources”, “patient considerations and positioning”, “establishment and physiology of the pneumoperitoneum & abdominal access and trocar placement”, “tissue handling, exposure and examination of the abdomen and pelvis & hemorrhage and hemostasis & tissue approximation”, and “exiting the abdomen and postoperative care”. Domains of “anesthesia” and “biopsy techniques” were excluded in this assessment. Scores were compared between post-graduate year (PGY) >5 and PGY1-5 participants. Data are expressed as median score and interquartile range. Wilcoxon signed-rank test determined significance.
RESULTS: A total of 45 surgeons and surgical trainees of all years from 5 teaching hospitals (PGY1-5: 23, PGY>5: 22) completed the examination (mean age 34; 87% male). The median score in the entire cohort was 75 [65; 83]% (range=38-92%), with significantly higher scores in the PGY>5 group compared to the PGY1-5 group (67 [58; 75] vs. 81 [74; 84], p<0.001). The differences in performances were due to better scores for PGY>5 group on the sections “equipment and energy sources”, “tissue handling, exposure and examination & hemorrhage and hemostasis & tissue approximation”, and “exiting the abdomen and postoperative care”. Among all participants, the median scores in the subsection of “energy sources (50 [50; 100]%)” and “establishment and physiology of the pneumoperitoneum (50 [38; 75]%)” were lower than the other domains. All participants agreed to a need for learning fundamental knowledge (strongly agree 71%; agree 29%) and formal educational curricula (strongly agree 53%; agree 47%).
CONCLUSIONS: The preliminary results show surgical trainees have less knowledge required for laparoscopic surgery compared to experienced surgeons. There is a need for a formal education curriculum such as FLS to help address this knowledge gap and contribute to safer laparoscopic surgery.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79543
Program Number: P294
Presentation Session: Poster (Non CME)
Presentation Type: Poster
