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Inicio Actas Urológicas Españolas (English Edition) Onset of a training program for single-port laparoscopic urology
Journal Information
Vol. 36. Issue 7.
Pages 418-424 (July - August 2012)
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Vol. 36. Issue 7.
Pages 418-424 (July - August 2012)
Original article
Onset of a training program for single-port laparoscopic urology
Puesta en marcha de un programa de entrenamiento para laparoscopia urológica por puerto único
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1591
F. Cáceres, P.M. Cabrera, E. Mateo, G. Andrés, F. Lista, A. García-Tello, J.C. Angulo
Corresponding author
jangulo.hugf@salud.madrid.org

Corresponding author.
Hospital Universitario de Getafe, Fundación para la Investigación Biomédica, Servicio Madrileño de Salud, Universidad Europea de Madrid, Madrid, Spain
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Tables (2)
Table 1. Descriptive analysis of surgical times for each surgery.
Table 2. Comparison of surgical times between the first half of cases (group A) and the second half (group B).
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Abstract
Objectives

To describe the onset of a single port laparoendoscopic program to carry out oncology surgery in a Urology Service. We present the initial experience in the laboratory and in the Animal Facility with rigid precurved instruments and KeyPort reusable access element (Richard Wolf).

Materials and methods

Two surgeons experienced in laparoscopic surgery and with the help of four assistants performed a training program based on predetermined tasks performed in simulation boxes (pelvitrainer) and porcine model following the requirements of the Regional Community of Madrid to handle experimental animals.

Results

The participants in this program were initially divided into pairs made up of an experienced surgeon and assistant for the predetermined multiple tasks in simulator box in order to become familiarized with the instruments. Then, 20 animal sessions were conducted in which the following were performed: (retroperitoneal or pelvic) lymph node dissections (n=20), nephrectomies (n=40), cystorrhaphy with suture (n=20) and uterine-vesical anastomosis (n=20). Time needed to perform the exercises and the principal errors perceived during the performance of each one of the tasks were recorded. The tasks, of growing complexity, were performed with the instruments described in increasingly less time and with less difficulty. An accessory trocar of 3.5mm was required to perform the in vivo sutures.

Conclusions

The KeyPort approach has potential application in different urological applications. Standardized training allows the acquirement of skills and makes the successful implementation of a laparoendoscopic surgery program in humans possible.

Keywords:
Single-port
Laparoscopy
Teaching
Medical education
Resumen
Objetivos

Describir el inicio de un programa de laparoendoscopia a través de puerto único para llevar a cabo la cirugía oncológica de un Servicio de Urología. Presentamos la experiencia inicial en laboratorio y en animalario con instrumentos precurvados rígidos y elemento de acceso reutilizable tipo KeyPort (Richard Wolf).

Material y métodos

Dos cirujanos experimentados en cirugía laparoscópica, con la ayuda de 4 ayudantes, llevaron a cabo un programa de entrenamiento mediante tareas predeterminadas en caja de simulación y en modelo suido, siguiendo los requisitos de la Comunidad Autónoma de Madrid para el manejo de animales de experimentación.

Resultados

Los participantes en este programa inicialmente se dividieron en parejas compuestas por cirujano experimentado y ayudante para la realización de múltiples tareas predeterminadas en la caja de simulación, con intención de familiarizarse con los instrumentos. Seguidamente se llevaron a cabo 20 sesiones animales en las que se realizaron disecciones ganglionares (pélvica o retroperitoneal) (n=20), nefrectomías (n=40), cistorrafias con sutura (n=20) y anastomosis uterino-vesicales (n=20). Se registraron los tiempos necesarios para la realización de los ejercicios y los principales errores percibidos en la realización de cada una de las tareas. Las tareas de complejidad creciente fueron realizadas con el instrumental descrito cada vez en menor tiempo y con menos dificultad. Se precisó un trócar accesorio de 3,5mm para la realización de las suturas in vivo.

Conclusiones

El abordaje KeyPort tiene aplicación potencial en diferentes aplicaciones urológicas. Un entrenamiento reglado permite la adquisición de destrezas y posibilita la implantación con éxito de un programa de cirugía laparoendoscópica en humanos.

Palabras clave:
Puerto único
Laparoscopia
Enseñanza
Educación médica

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