在腹腔镜修复中标准化和学习曲线:高体积中心的经验
Francesco Brucchi1,2, Federica Ferraina3,4, Emilia Masci4
1Department of General Surgery, Sesto San Giovanni Hospital, Viale Matteotti, 83, Milan, MI, 20099, Italy. brucchi.francesco@gmail.com.
BMC surgery
|July 28, 2023
概括
跨腹前腹腔 (TAPP) 沟膜整形术是训练外科医生的安全有效的腹腔镜技术. 一个标准化的方法需要大约100个程序的熟练程度,显示低的并发症和复发率.
科学领域:
- 一般外科 整体外科
- 最少侵入性的手术
背景情况:
- 沟是常见的,手术修复的选择包括开放式和腹腔镜技术.
- 腹腔镜手术提供了好处,但由于解剖学复杂性,需要先进的技能.
- 穿越腹腔前腹膜 (TAPP) 膜整形术是一种腹腔镜治疗沟的方法.
研究的目的:
- 提出一个标准化,系统的方法来TAPP沟膜整形.
- 评估TAPP对于培养年轻外科医生的适用性.
- 在大型系列中证明TAPP的安全性和有效性.
主要方法:
- 一个详细的,逐步描述TAPP程序的步骤.
- 分析了487次修复手术,其中168次由正在培训的外科医生进行.
- 对手术结果,并发症率和手术时间的描述性分析.
主要成果:
- 低的并发症率 (0.41%) 和复发率 (0.41%).
- 经验丰富的外科医生平均手术时间为55分钟,受训医生为93分钟.
- 塔普在复发和恢复方面表现出与公开修复相似的结果.
结论:
- TAPP是一种可行且有效的沟修复技术,与开放式手术相当.
- 这项研究挑战了人们认为TAPP不适合外科实习生的观点.
- 一个结构化的培训路径,涉及大约100个程序,可以导致TAPP熟练.
相关概念视频
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