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Teaching and Training for Laparoscopic Colorectal Resection

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Complexities in Colorectal Surgery

Abstract

Despite a large amount of evidence demonstrating that colectomy outcomes are, in general, improved with use of a laparoscopic approach compared to traditional open surgery, there is a clear lack of data addressing the best method of education for safe adoption of this technology. Furthermore, it has been over 20 years since the first reports of laparoscopic colectomy were published, and still over half of all colectomies are performed via laparotomy. While industry, surgical societies, and individual institutions have all made substantial contributions in attempt to bridge this gap, there are still several hurdles to overcome. In this chapter, we address the current barriers to more widespread adoption of laparoscopic colectomy and explore various methods available for the training and assessment of both residents and attending surgeons performing this procedure.

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References

  1. Steele SR, Brown TA, Rush RM. Laparoscopic vs. open colectomy for colon cancer: results from a large nationwide population-based analysis. J Gastrointest Surg. 2008;12:583–91.

    Article  PubMed  Google Scholar 

  2. Delaney CP, Change E, Senagore AJ, Broder M. Clinical outcomes and resource utilization associated with laparoscopic and open colectomy using a large national database. Ann Surg. 2008;247(5):819–24.

    Article  PubMed  Google Scholar 

  3. Hayes JL, Hansen P. Is laparoscopic colectomy for cancer cost effective relative to open colectomy? ANZ J Surg. 2007;77:782–6.

    Article  PubMed  Google Scholar 

  4. Varela JE, Asolati M, Huerta S, Anthony T. Outcomes of laparoscopic and open colectomy at academic centers. Am J Surg. 2008;196:403–6.

    Article  PubMed  Google Scholar 

  5. Lacy AM, Garcia-Valdecasas JC, Delgado S. Laparoscopic-assisted colectomy vs. open colectomy for treatment of non-metastatic colon cancer: a randomized trial. Lancet. 2002;359:2224–9.

    Article  PubMed  Google Scholar 

  6. Kennedy GD, Heise C, Rajamanickam V, Harms B, Foley EF. Laparoscopy decreases postoperative complication rates after abdominal colectomy. Ann Surg. 2009;249:596–601.

    Article  PubMed  Google Scholar 

  7. Kang CY, Chaudhry OO, Halabi WJ, et al. Outcomes of laparoscopic colorectal surgery: data from the Nationwide Inpatient Sample 2009. Am J Surg. 2012;204(6):952–7.

    Article  PubMed  Google Scholar 

  8. Senagore AJ, Luchtefeld MA, Mackeigan JM. What is the learning curve for laparoscopic colectomy? Am Surg. 1995;61:681–5.

    CAS  PubMed  Google Scholar 

  9. Schlata CM, Mamazza J, Seshadri PA, Cadeddu M, Gregoire R, Poulin EC. Defining a learning curve for laparoscopic colorectal resections. Dis Colon Rectum. 2001;44:217–22.

    Article  Google Scholar 

  10. Dincler S, Koller MT, Steurer J, Bachmann LM, Christen D, Buchmann P. Multidimensional analysis of learning curves in laparoscopic sigmoid resection: eight year results. Dis Colon Rectum. 2003;46:1371–3.

    Article  PubMed  Google Scholar 

  11. Stein SL, Sulberg J, Champagne BJ. Learning laparoscopic colectomy during colorectal residency: what does it take and how are we doing? Surg Endosc. 2012;26:488–92.

    Article  PubMed  Google Scholar 

  12. Charron P, Campbell R, DeJesus S, Gallagher J, Williamson P, Ferrara A. The gap in laparoscopic colorectal experience between colon and rectal and general surgery residency training programs. Dis Colon Rectum. 2007;50:2023–31.

    Article  PubMed  Google Scholar 

  13. Alkhoury F, Martin JT, Contessa J, et al. The impact of laparoscopy on the volume of open cases in general surgery training. J Surg Educ. 2010;67(5):316–9.

    Article  PubMed  Google Scholar 

  14. Weber WP, Guller U, Jain NB, et al. Impact of surgeon and hospital caseload on the likelihood of performing laparoscopic vs open sigmoid resection for diverticular disease: a study based on 55,949 patients. Arch Surg. 2007;142:253–9.

    Article  PubMed  Google Scholar 

  15. Pugh CM, Darosa DA, Santacaterina S, Clark RE. Faculty evaluation of simulation-based modules for assessment of intraoperative decision making. Surgery. 2011;149(4):534–42.

    Article  CAS  PubMed  Google Scholar 

  16. Stain SC, Biester TW, Hanks JB, et al. Early tracking would improve the operative experience of general surgery residents. Ann Surg. 2010;252(3):445–9; discussion 449–51.

    PubMed  Google Scholar 

  17. Drolet BC, Sangisetty S, Tracy TF, et al. Surgical residents’ perceptions of 2011 accreditation council for graduate medical education duty hour regulations. JAMA Surg. 2013;148(5):427–33.

    Article  PubMed  Google Scholar 

  18. Roberts NK, Williams RG. The briefing, intraoperative teaching, debriefing model for teaching in the operating room. J Am Coll Surg. 2008;10:299–303.

    Google Scholar 

  19. Roberts KE, Bell RL, et al. Evolution of surgical skills training. World J Gastroenterol. 2006;12(20):3219–24.

    PubMed  Google Scholar 

  20. Crochet P, Aggarwal R, Dubb SS, et al. Deliberate practice on a virtual reality laparoscopic simulator enhances the quality of surgical technical. Ann Surg. 2011;253(6):1216–22.

    Article  PubMed  Google Scholar 

  21. Grantcharov TP, Kristiansen VB, Bendix J, et al. Randomized clinical trial of virtual reality simulation for laparoscopic skills training. Br J Surg. 2004;91(2):146–50.

    Article  CAS  PubMed  Google Scholar 

  22. Beyer L, Troyer JD, Mancini J, Bladou F, Berdah SV, Karsenty G. Impact of laparoscopy simulator training on the technical skills of future surgeons in the operating room: a prospective study. Am J Surg. 2011;202(3):265–72.

    Article  PubMed  Google Scholar 

  23. LeBlanc F, Champagne BJ, Augestad KM, Neary PC, Senagore AJ, Ellis CN, Delaney CP, Colorectal Surgery Training Group. A comparison of human cadaver and augmented reality simulator models for straight laparoscopic colorectal skills acquisition training. J Am Coll Surg. 2012;211(2):250–5.

    Article  Google Scholar 

  24. McDougall EM, Corica FA, Boker JR, Sala LG, Stoliar G, Borin JF, Chu FT, Clayman RV. Construct validity testing of a laparoscopic surgical simulator. J Am Coll Surg. 2006;202:779–87.

    Article  PubMed  Google Scholar 

  25. Zhang A, Hünerbein M, Dai Y, Schlag PM, Beller S. Construct validity testing of a laparoscopic surgery simulator (Lap Mentor): evaluation of surgical skill with a virtual laparoscopic training simulator. Surg Endosc. 2008;22:1440–4.

    Article  PubMed  Google Scholar 

  26. Champagne BJ, Shanmugan S, Leblanc F, et al. Virtual reality training on the GI mentor laparoscopic sigmoid model: what metrics have construct validity. Dis Colon Rectum. 2013 (in press).

    Google Scholar 

  27. Palter VN, Grantcharov TP. Development and validation of a comprehensive curriculum to teach an advanced minimally invasive procedure: a randomized controlled trial. Ann Surg. 2012;256(1):25–32.

    Google Scholar 

  28. Calatayud MD, Arora S. Warm-up in a virtual reality environment improves performance in the operating room. Ann Surg. 2010;251:1181–5.

    Article  PubMed  Google Scholar 

  29. Snyder RA, Tarpley MJ, Tarpley JL, Davidson M, Brophy C, Dattilo JB. Teaching in the operating room: results of a national survey. J Surg Educ. 2012;69(5):643.

    Article  PubMed  Google Scholar 

  30. DeGrave WS, Dolmans DH, Van Der Vleuten CP. Profiles of effective tutors in problem-based learning: scaffolding student learning. Med Educ. 1999;33(12):901–6.

    Article  CAS  Google Scholar 

  31. Carter BN. The fruition of Halsted’s concept of surgical training. Surgery. 1952;32:518–27.

    CAS  PubMed  Google Scholar 

  32. Whitson BA, Hoang CD, Jie T, Maddaus MA. Technology-enhanced interactive surgical education. J Surg Res. 2006;136(1):13–8.

    Article  PubMed  Google Scholar 

  33. Roberts NK, Brenner MJ, et al. Capturing the teachable moment: a grounded theory study of verbal teaching interactions in the operating room. Surgery. 2012;151:643–50.

    Article  PubMed  Google Scholar 

  34. Kim MJ, Boehler ML. Skills coaches as part of the educational team: a randomized controlled trial of teaching of a basic surgical skill in the laboratory setting. Am J Surg. 2010;199:94–8.

    Article  PubMed  Google Scholar 

  35. Chen X, Williams R, et al. How do supervising surgeons evaluate guidance provided in the operating room? Am J Surg. 2012;203:44–8.

    Article  PubMed  Google Scholar 

  36. Sanfey HA, Dunnington GL. Basic surgical skills testing for junior residents: current views of general surgery program directors. J Am Coll Surg. 2011;212:406–12.

    Article  PubMed  Google Scholar 

  37. Martin JA, Regehr G, et al. Objective structured assessment of technical skill (OSATS) for surgical residents. Br J Surg. 1997;84(2):273–8.

    Article  CAS  PubMed  Google Scholar 

  38. Kim MJ, Williams RG, Boehler ML, et al. Refining the evaluation of operating room performance. J Surg Educ. 2009;66(6):352–6.

    Google Scholar 

  39. Miskovic D, Wyles S, et al. Development, validation and implementation of a monitoring tool for training in laparoscopic colorectal surgery in the English National Training Program. Surg Endosc. 2011;25:1136–42.

    Article  PubMed  Google Scholar 

  40. Miskovic D, Ni M, et al. Observational clinical human reliability analysis for competency assessment in laparoscopic colorectal surgery at the specialist level. Surg Endosc. 2012;26:796–803.

    Article  PubMed  Google Scholar 

  41. Palter VN, Graafland M, Schijven MP, Grantcharov TP. Designing a proficiency-based, content validated virtual reality curriculum for laparoscopic colorectal surgery: a Delphi approach. Surgery. 2012;151(3):391–7.

    Article  PubMed  Google Scholar 

  42. Ross HM, Simmang CL, Fleshman JW, Marcello PW. Adoption of laparoscopic colectomy: results and implications of ASCRS hands-on course participation. Surg Innov. 2008;15(3):179–83.

    Article  PubMed  Google Scholar 

  43. Ho VP, Trencheva K, Stein SL, Milsom JW. Mentorship for participants in a laparoscopic colectomy course. Surg Endosc. 2012;26(3):722–6.

    Article  PubMed  Google Scholar 

  44. Sarker SJ, Telfah MM, Onuba L, et al. Objective assessment of skills acquisition during laparoscopic surgery courses. Surg Innov. 2013;20(5):530–8

    Google Scholar 

  45. Miskovic D, Ni M, Wyles SM, Kennedy RH, et al. Is competency assessment at the specialist level achievable? A study for the national training programme in laparoscopic colorectal surgery in England. National Training Programme in Laparoscopic Colorectal Surgery in England. Ann Surg. 2013;257(3):476–82.

    Article  PubMed  Google Scholar 

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Correspondence to Bradley J. Champagne MD .

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Champagne, B.J., MacRae, H. (2014). Teaching and Training for Laparoscopic Colorectal Resection. In: Steele, S.R., Maykel, J.A., Champagne, B.J., Orangio, G.R. (eds) Complexities in Colorectal Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-9022-7_37

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  • DOI: https://doi.org/10.1007/978-1-4614-9022-7_37

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