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Usefulness of a stepwise training program for laparoscopic gastrectomy.

Masaaki Nishi¹, Mitsuo Shimada¹, Kozo Yoshikawa¹

¹Department of Surgery, University of Tokushima Graduate School, Tokushima, Japan.

Asian Journal of Endoscopic Surgery

|September 13, 2021

Summary

A stepwise training program significantly reduced operative time and blood loss for laparoscopic gastrectomy (LG) surgeons. This structured approach enhances surgical quality and patient outcomes in complex procedures.

Keywords:

gastric cancer laparoscopic gastrectomy stepwise training

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Area of Science:

Surgical Education
Minimally Invasive Surgery
Gastrointestinal Surgery

Background:

Laparoscopic gastrectomy (LG) presents a steep learning curve for surgeons.
Improving surgical quality in LG is crucial for patient outcomes.

Purpose of the Study:

To evaluate the effectiveness of a novel stepwise training program for laparoscopic gastrectomy.
To assess the program's impact on surgical outcomes such as operative time and blood loss.

Main Methods:

A four-step training program was implemented: basic dry box training, animal/cadaveric training, clinical experience with 3D simulation, and self-assessment.
153 patients undergoing curative gastrectomy for gastric cancer were included in the study.

Main Results:

Significant reductions in operative time were observed for both laparoscopic distal gastrectomy (LDG) and laparoscopic total gastrectomy (LTG) between 2013 and 2017.
Blood loss volumes also decreased significantly for both LDG and LTG during the study period.
Statistical analysis showed significant negative correlations between training progression and both operative time and blood loss.

Conclusions:

The stepwise training program effectively reduces operative time and blood loss in laparoscopic gastrectomy.
This structured training methodology enhances the quality and efficiency of LG procedures.