Ruben Avila, MD1, Achurra Pablo, MD1, Tejos Rodrigo, MD1, Pacheco Sergio, MD1, Erwin Buckel, MD1, Rebolledo Rolando, PhD1, Leon Felipe, MD1, Juan Ramos, MD2, Marcel Sanhueza, MD1, Nicolas Jarufe, MD1, Julian Varas, MD1. 1Pontificia Universidad Católica de Chile, 2Hospital Dr Sotero del Rio
Introduction: Simulation could give the necessary training to complete long and complex curves of knowledge in laparoscopic hepatic surgery in centres with low to medium volume.
Objectives: Present a training programme of advanced laparoscopic hepatic surgery and evaluate how obtained skills are shown in operation rooms.
Materials and Methods: Fase-1: Two experts surgeons trained in a live sheep model, carrying twelve left hepatectomy totally laparoscopic (LHTL). All the procedures were filmed and blindly analysed by two experts using validated global and specific scales. Other variables recorded were operatory time, mortality, vascular control, hematic loss and quality of parenchymal transaction.
Fase-2: Fase-1 experts trained four digestive surgery residents during training sessions until they performed LHTL with optimal parameters.
Fase-3: Once completed the simulation trained residents carried out a LHTL in one patient. For the analysis of results analytic statistics was used for nonparametric variables; Wilcoxon and McNemar test.
Results: Based on global scales scores, learning curves were obtained during each session of Fase-1 and Fase-2. Scores in global scales significantly improved between first and last surgery for both experts and residents (p<0.01). There were non significant differences between overall scores obtained by experts and residents at the end of training. Residents required an average of six sessions to acquire the skills (range of four to eight). During Fase-3 residents performed LHTL in patients without incidents.
Conclusions: Training in a sheep model allows the acquisition of skills to perform laparoscopic liver surgery both in experts and digestive surgery residents. The technical skills obtained are transferred to the operation room.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80573
Program Number: P280
Presentation Session: Poster (Non CME)
Presentation Type: Poster
