Download PDF
Clin Colon Rectal Surg 2021; 34(03): 194-200
DOI: 10.1055/s-0041-1722843
Review Article

Training on Minimally Invasive Colorectal Surgery during Surgical Residency: Integrating Surgical Education and Advanced Techniques

Martina Nebbia
1   Department of Surgery, Colon and Rectal Surgery Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
,
Paulo Gustavo Kotze
2   Colorectal Surgery Unit, IBD Outpatient Clinics, Health Sciences Postgraduate Program, Catholic University of Paraná (PUCPR), Curitiba, Brazil
,
Antonino Spinelli
3   Division of Colon and Rectal Surgery, Humanitas Clinical and Research Center, IRCCS Humanitas University, Department of Biomedical Sciences, Rozzano, Milan, Italy
› Author Affiliations
› Further Information
    Permissions and Reprints

Abstract

Surgery is an ever-evolving discipline and continually incorporates new technologies that have improved the ability of the operating room surgeon to perform. The next generation of minimally invasive surgery includes laparoscopic and robotic-assisted procedures. Graduating residents may be expected to have the skills to perform common colorectal procedures using these technologies, and residency programs are developing curriculums to teach these skills. Minimally invasive techniques are challenging and learning only by observation and practice alone is difficult. This requires dedicated training and mentoring.

New simulation methods have been conceived specifically for minimally invasive procedures, and these embrace a combination of virtual reality simulators and box trainers, with animal and human tissue, as well as synthetic materials. The aim of this review is to provide an overview of training in minimally invasive colorectal surgery with a focus on different types of simulators that build the basis to develop and include a multistep training approach in a structured training curriculum for minimally invasive colorectal procedures.

Keywords

minimally invasive technique - training - colorectal surgery - virtual reality simulator


Publication History

Article published online:
29 March 2021

© 2021. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Cameron JL. William Stewart Halsted. Our surgical heritage. Ann Surg 1997; 225 (05) 445-458
    CrossrefPubMedGoogle Scholar
  • 2 Tekkis PP, Senagore AJ, Delaney CP, Fazio VW. Evaluation of the learning curve in laparoscopic colorectal surgery: comparison of right-sided and left-sided resections. Ann Surg 2005; 242 (01) 83-91
    CrossrefPubMedGoogle Scholar
  • 3 Choi DH, Jeong WK, Lim SW. et al. Learning curves for laparoscopic sigmoidectomy used to manage curable sigmoid colon cancer: single-institute, three-surgeon experience. Surg Endosc 2009; 23 (03) 622-628
    CrossrefPubMedGoogle Scholar
  • 4 Miskovic D, Wyles SM, Ni M, Darzi AW, Hanna GB. Systematic review on mentoring and simulation in laparoscopic colorectal surgery. Ann Surg 2010; 252 (06) 943-951
    CrossrefPubMedGoogle Scholar
  • 5 Meyers WC. The New England Journal of Medicine as published by New England Journal of Medicine. Available at: www.nejm.org. Accessed August 10, 2010. For personal use only. No other uses without permission. Copyright © 1991 Massachusetts Medical Society. All rights reser. 1991
    PubMedGoogle Scholar
  • 6 Kotsis SV, Chung KC. Application of the “see one, do one, teach one” concept in surgical training. Plast Reconstr Surg 2013; 131 (05) 1194-1201
    CrossrefPubMedGoogle Scholar
  • 7 Scott DJ, Bergen PC, Rege RV. et al. Laparoscopic training on bench models: better and more cost effective than operating room experience?. J Am Coll Surg 2000; 191 (03) 272-283
    CrossrefPubMedGoogle Scholar
  • 8 Smith CD, Farrell TM, McNatt SS, Metreveli RE. Assessing laparoscopic manipulative skills. Am J Surg 2001; 181 (06) 547-550
    CrossrefPubMedGoogle Scholar
  • 9 Bell Jr RH, Biester TW, Tabuenca A. et al. Operative experience of residents in US general surgery programs: a gap between expectation and experience. Ann Surg 2009; 249 (05) 719-724
    CrossrefPubMedGoogle Scholar
  • 10 Bass BL. Matching training to practice: the next step. Ann Surg 2006; 243 (04) 436-438
    CrossrefPubMedGoogle Scholar
  • 11 Pugh CM, Darosa DA, Bell Jr RH. Residents' self-reported learning needs for intraoperative knowledge: are we missing the bar?. Am J Surg 2010; 199 (04) 562-565
    CrossrefPubMedGoogle Scholar
  • 12 Park J, MacRae H, Musselman LJ. et al. Randomized controlled trial of virtual reality simulator training: transfer to live patients. Am J Surg 2007; 194 (02) 205-211
    CrossrefPubMedGoogle Scholar
  • 13 Bridges M, Diamond DL. The financial impact of teaching surgical residents in the operating room. Am J Surg 1999; 177 (01) 28-32
    CrossrefPubMedGoogle Scholar
  • 14 Moore MJ, Bennett CL. The learning curve for laparoscopic cholecystectomy. The Southern Surgeons Club. Am J Surg 1995; 170 (01) 55-59
    CrossrefPubMedGoogle Scholar
  • 15 Kim J, Edwards E, Bowne W. et al. Medial-to-lateral laparoscopic colon resection: a view beyond the learning curve. Surg Endosc 2007; 21 (09) 1503-1507
    CrossrefPubMedGoogle Scholar
  • 16 Sheckter CC, Kane JT, Minneti M. et al. Incorporation of fresh tissue surgical simulation into plastic surgery education: maximizing extraclinical surgical experience. J Surg Educ 2013; 70 (04) 466-474
    CrossrefPubMedGoogle Scholar
  • 17 Kettle KL, Häubl G. Motivation by anticipation: expecting rapid feedback enhances performance. Psychol Sci 2010; 21 (04) 545-547
    CrossrefPubMedGoogle Scholar
  • 18 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 (03) 179-183
    CrossrefPubMedGoogle Scholar
  • 19 Panait L, Bell RL, Roberts KE, Duffy AJ. Designing and validating a customized virtual reality-based laparoscopic skills curriculum. J Surg Educ 2008; 65 (06) 413-417
    CrossrefPubMedGoogle Scholar
  • 20 Poulin EC, Gagné JP, Boushey RP. Advanced laparoscopic skills acquisition: the case of laparoscopic colorectal surgery. Surg Clin North Am 2006; 86 (04) 987-1004
    CrossrefPubMedGoogle Scholar
  • 21 Schmitz CC, Chow CJ, Rothenberger DA. Colorectal surgeons teaching general surgery residents: current challenges and opportunities. Clin Colon Rectal Surg 2012; 25 (03) 134-142
    Article in Thieme ConnectPubMedGoogle Scholar
  • 22 Curriculum IS. The Intercollegiate Surgical Curriculum Educating the Surgeons of the Future. Vol. 2010. 2013
    Google Scholar
  • 23 Parmar S, Delaney CP. The role of proximate feedback in skills training. Surgeon 2011; 9 (Suppl. 01) S26-S27
    CrossrefPubMedGoogle Scholar
  • 24 Aggarwal R, Ward J, Balasundaram I, Sains P, Athanasiou T, Darzi A. Proving the effectiveness of virtual reality simulation for training in laparoscopic surgery. Ann Surg 2007; 246 (05) 771-779
    CrossrefPubMedGoogle Scholar
  • 25 Accessed September 7, 2020 at: https://www.escp.eu.com
    PubMed
  • 26 Accessed September 7, 2020 at: https://www.fascrs.org
    PubMed
  • 27 Accessed September 7, 2020 at: https://www.cssanz.org
    PubMed
  • 28 Samia H, Khan S, Lawrence J, Delaney CP. Simulation and its role in training. Clin Colon Rectal Surg 2013; 26 (01) 47-55
    Article in Thieme ConnectPubMedGoogle Scholar
  • 29 Korndorffer Jr JR, Dunne JB, Sierra R, Stefanidis D, Touchard CL, Scott DJ. Simulator training for laparoscopic suturing using performance goals translates to the operating room. J Am Coll Surg 2005; 201 (01) 23-29
    CrossrefPubMedGoogle Scholar
  • 30 Chambers S, Deehan D, Gillinder S, Holland J. Cadaveric surgical training improves surgeon confidence. Bull R Coll Surg Engl 2015; 97 (01) E1-E4
    CrossrefPubMedGoogle Scholar
  • 31 Lucas SM, Zeltser IS, Bensalah K. et al. Training on a virtual reality laparoscopic simulator improves performance of an unfamiliar live laparoscopic procedure. J Urol 2008; 180 (06) 2588-2591 , discussion 2591
    CrossrefPubMedGoogle Scholar
  • 32 Thompson JR, Leonard AC, Doarn CR, Roesch MJ, Broderick TJ. Limited value of haptics in virtual reality laparoscopic cholecystectomy training. Surg Endosc 2011; 25 (04) 1107-1114
    CrossrefPubMedGoogle Scholar
  • 33 Sylla P, Rattner DW, Delgado S, Lacy AM. NOTES transanal rectal cancer resection using transanal endoscopic microsurgery and laparoscopic assistance. Surg Endosc 2010; 24 (05) 1205-1210
    CrossrefPubMedGoogle Scholar
  • 34 Faiz O, Warusavitarne J, Bottle A, Tekkis PP, Darzi AW, Kennedy RH. Laparoscopically assisted vs. open elective colonic and rectal resection: a comparison of outcomes in English National Health Service Trusts between 1996 and 2006. Dis Colon Rectum 2009; 52 (10) 1695-1704
    CrossrefPubMedGoogle Scholar
  • 35 Liyanage C, Ramwell A, Harris GJ, Levy BF, Simson JNL. Transanal endoscopic microsurgery: a new technique for completion proctectomy. Colorectal Dis 2013; 15 (09) e542-e547
    CrossrefPubMedGoogle Scholar
  • 36 Sutherland LM, Middleton PF, Anthony A. et al. Surgical simulation: a systematic review. Ann Surg 2006; 243 (03) 291-300
    CrossrefPubMedGoogle Scholar
  • 37 Dawe SR, Pena GN, Windsor JA. et al. Systematic review of skills transfer after surgical simulation-based training. Br J Surg 2014; 101 (09) 1063-1076
    CrossrefPubMedGoogle Scholar
  • 38 Grantcharov TP, Kristiansen VB, Bendix J, Bardram L, Rosenberg J, Funch-Jensen P. Randomized clinical trial of virtual reality simulation for laparoscopic skills training. Br J Surg 2004; 91 (02) 146-150
    CrossrefPubMedGoogle Scholar