Publication: Una experiencia de integración de la formación sanitaria especializada con la Universitaria de Posgrado: Entrenamiento por etapas en cirugíalaparoscópica
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Date
2020
Authors
Flores Funes, Diego ; Pellicer Franco, Enrique Manuel ; Flores Pastor, Benito Manuel ; Moreno Cascales, Matilde ; Fernández Villacañas-Marín, Miguel Ángel ; Aguayo Albasini, José Luis
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Publisher
Centro de Estudios en Educación Médica de la Universidad de Murcia (CeuEM) y Editum (Servicio de Publicaciones de la Universidad de Murcia)
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Description
Abstract
Antecedentes: Diseño de un modelo de simulación para formación encirugía laparoscópica. Métodos: Dentro del Máster Anatomía Aplicada a la Clínica seimplementaron tres etapas de formación progresiva en médicos residentes. La etapa1 se realizó en simulador con material no biológico: manejo de objetos, disección conpinza y tijera, y sutura laparoscópica. La etapa 2 utilizó material biológico (tubodigestivo en fresco) en simulador, para la práctica de sección intestinal yanastomosis intracorpórea. En la etapa 3 se realizaron técnicas laparoscópicas encadáver en fresco (apendicectomía, colecistectomía, apertura de la transcavidadepiploica, hemicolectomías derecha e izquierda). Se añadió una encuesta desatisfacción a los participantes de la actividad. Resultados: El programa se impartió a6 residentes de Cirugía General. Todos completaron los ejercicios de las etapas 1 y 2.En la etapa 3 se pudo realizarel neumoperitoneo sin dificultad y los tejidospresentaron una textura adecuada. Los residentes de primer año completaron laapendicectomía y la colecistectomía, pero procedimientos más complejos requirieronresidentes con más experiencia. Los participantes encuestados reflejaron que elprograma es adecuado y útil para el entrenamiento en laparoscopia. Conclusiones: Elmodelo propuesto es reproducible y adecuado en adquisición de competenciasbásicas en cirugía laparoscópica.
Abstract: Background: Design of a simulation model training in laparoscopic surgeryfor surgical residents. Methods: Three stages of progressive training wereprogrammed within a Postgraduate Degree in Clinical Anatomy. Stage 1 wasperformed in a box-trainer with synthetic materials: managing small objects,dissection with clamp and scissors, and laparoscopic intracorporeal suture. Stage 2used biological material (fresh digestive tract from a human corpse) in box-trainer,practicing section and intracorporeal anastomosis. In stage 3, laparoscopy wasperformed on a fresh corpse (appendectomy, cholecystectomy, lesser sac opening,right and left colectomy). A satisfaction survey was carried out to the participants.Results: Some six General and Digestive Surgery residents took the program. All ofthem completed the stage 1 and 2 exercises. In stage 3, the pneumoperitoneum couldbe performed without any complications, and tissues presented an adequate texture.First-year residents completed appendectomy and cholecystectomy, but morecomplex procedures required more experienced residents. The participants reflectedthat the program is adequate and useful to gain basic skills in laparoscopy.Conclusions: The proposed model is reproducible and adequate in acquisition ofbasic skills in laparoscopic surgery.
Abstract: Background: Design of a simulation model training in laparoscopic surgeryfor surgical residents. Methods: Three stages of progressive training wereprogrammed within a Postgraduate Degree in Clinical Anatomy. Stage 1 wasperformed in a box-trainer with synthetic materials: managing small objects,dissection with clamp and scissors, and laparoscopic intracorporeal suture. Stage 2used biological material (fresh digestive tract from a human corpse) in box-trainer,practicing section and intracorporeal anastomosis. In stage 3, laparoscopy wasperformed on a fresh corpse (appendectomy, cholecystectomy, lesser sac opening,right and left colectomy). A satisfaction survey was carried out to the participants.Results: Some six General and Digestive Surgery residents took the program. All ofthem completed the stage 1 and 2 exercises. In stage 3, the pneumoperitoneum couldbe performed without any complications, and tissues presented an adequate texture.First-year residents completed appendectomy and cholecystectomy, but morecomplex procedures required more experienced residents. The participants reflectedthat the program is adequate and useful to gain basic skills in laparoscopy.Conclusions: The proposed model is reproducible and adequate in acquisition ofbasic skills in laparoscopic surgery.
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