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Specific training for LESS surgery results from a prospective study in the animal model
Giovannni Scala Marchini1,2, Italo D Fioravanti1, Leonardo V Horta1
1Instituto de Ensino e Pesquisa do Hospital Sírio Libanês, São Paulo, Brasil.
Summary
Post-graduate students demonstrated proficiency in single-port total nephrectomies in an animal model. While feasible, the procedure presented challenges, with intraoperative complications managed effectively via the single-port system.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Surgical Education
Background:
- Laparoscopic surgery is a cornerstone of modern urology.
- Single-port laparoscopic surgery offers potential advantages in reduced invasiveness.
- Assessing the learning curve for new surgical techniques is crucial for trainee development.
Purpose of the Study:
- To evaluate the proficiency of post-graduate students in performing single-port total nephrectomies.
- To analyze the feasibility and outcomes of single-port total nephrectomy in an animal model.
- To identify potential challenges and complications associated with this technique for trainees.
Main Methods:
- Prospective evaluation of 15 post-graduate students in a laparoscopy program.
- Procedures performed using the SILS™ port system for single-port surgery.
- Data collected on incision size, operative time, and complications for 30 nephrectomies.
Main Results:
- All students successfully completed single-port total nephrectomies.
- Mean incision size was 3.61 cm.
- Second procedures were significantly faster (45.8% for renal hilum, 38% for total operative time).
- Complications included vascular and organ injuries, managed laparoscopically, with one requiring an auxiliary port.
Conclusions:
- Single-port total nephrectomy is a feasible, though challenging, procedure for trainees with intermediate laparoscopic skills.
- Intraoperative complications can be managed effectively using the single-port system.
- Training focused on reducing surgical time and improving outcomes is recommended.
