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Effective stepwise training and procedure standardization for young surgeons to perform laparoscopic left hepatectomy
Shinichiro Yamada1, Mitsuo Shimada2, Satoru Imura2
1Department of Surgery, University of Tokushima, 3-18-15 Kuramoto-cho, Tokushima City, Tokushima, 770-8503, Japan. yamada.shinichiro@tokushima-u.ac.jp.
Background:
Laparoscopic hepatectomy remains one of the most difficult procedures for young surgeons to perform. We recently developed a new training method and standardization procedure for teaching young surgeons to perform laparoscopic left hepatectomy (Lap-LHx). The aim of this study was to assess the effectiveness of our method.
Methods:
In 2004, we standardized a laparoscopic procedure for Lap-LHx, using a laparoscopy-assisted method as a stepping stone. The laparoscopic training method comprised the following three steps: (1) training in fundamental procedures using a dry box and checking by mentors; (2) detailed preoperative simulation using Vincent three-dimensional software for each patient; and (3) self-assessment including understanding of relevant anatomy and completion grade for each procedure using a check sheet and feedback by both mentors and a professor. Twenty-three Lap-LHx procedures performed during the study period were divided into two groups: those performed by young non-board-certified surgeons (n = 9) and those performed by senior board-certified surgeons (n = 14).
Results:
The blood loss and operative time were similar in the young surgeon (194 g and 336 min, respectively) and senior surgeon groups (208 g and 322 min, respectively).
Conclusion:
Our standardized Lap-LHx procedure and stepwise training to perform it enable young surgeons to perform Lap-LHx as confidently and safely as more experienced surgeons.
