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Surgical laparoscopic experience during the first year on a teaching service
1Surgical Service, St. Luke's-Roosevelt Hospital Center, New York, New York.
Surgery, Gynecology & Obstetrics
|December 1, 1992
Summary
A structured training program effectively teaches surgical residents laparoscopic cholecystectomy. This program improved operative times and demonstrated a safe learning curve for residents performing this common surgical procedure.
Area of Science:
- General Surgery
- Surgical Education
Background:
- General surgeons are increasingly performing laparoscopic operations.
- Optimal training methods for surgical residents in laparoscopic surgery remain undefined.
Purpose of the Study:
- To evaluate the effectiveness of a formal laparoscopic cholecystectomy training program for surgical residents.
Main Methods:
- Implemented a comprehensive curriculum including syllabus, didactic lectures, inanimate simulation, and swine model practice.
- Residents progressed clinically from observer to operator roles.
- Documented operative times, complications, and outcomes for 90 laparoscopic cholecystectomies.
Main Results:
- Average operative time decreased from 93.2 minutes to 70 minutes as residents gained experience.
- Nine complications occurred, with no wound infections, bile duct injuries, or deaths.
- Complication rates did not correlate with surgeon experience level (resident vs. attending).
Conclusions:
- The structured laparoscopic surgery training program is successful in preparing residents.
- The program facilitates a safe and efficient learning curve for laparoscopic cholecystectomy.