Advertisement

Surgical Endoscopy

, Volume 22, Issue 4, pp 901–906 | Cite as

Laparoscopic training on Thiel human cadavers: A model to teach advanced laparoscopic procedures

  • Urs Giger
  • Isabelle Frésard
  • André Häfliger
  • Mathias Bergmann
  • Lukas Krähenbühl
Article

Abstract

Background

Nowadays, the laparoscopic approach represents the gold standard for a wide range of various basic and advanced procedures. To reduce the learning curve in advanced laparoscopic surgery, the search for new teaching tools is of utmost importance. Our experiences with a new teaching tool to train advanced laparoscopic procedures are reported.

Methods

Hands-on training courses in colon, hernia, bariatric and vascular surgery using Thiel human cadavers (THCs) were organised by the Swiss Association of Laparoscopic and Thoracoscopic Surgery (SALTS). The courses were held by consultant surgeons expert in the field of minimal invasive surgery (MIS). At the end of each course, data was collected using a standardised, anonymous questionnaire using a Likert scale (1 = strongly disagree; 2 = disagree; 3 = neither agree nor disagree; 4 = agree; 5 = strongly agree). Data are presented as mean ± standard deviation (SD), percentages (%) or total number (n), if indicated.

Results

From January 2005 to May 2006, six courses (colon = 2; hernia = 2; bariatric = 1; vascular = 1) were organized with a total of 33 participants (31 consultant surgeons; two senior residents). The authenticity of tissue colour, tissue consistency and operative tactility, respectively, were stated for the courses as follows: colon (mean: 4.4/4.2/4.2), hernia (mean: 4.3/4.2/4.0), bariatric (mean: 4.5/4.8/4.3) and vascular (mean: 2.8/2.8/2.6) courses. A high mean overall satisfaction with the courses (colon: 4.0; hernia: 4.2; bariatric: 5.0 and vascular surgery: 4.1) was also observed. All participants of the colon, bariatric, hernia and vascular courses will recommend the courses to other surgeons.

Conclusion

Training on THCs might be an excellent additional model to teach advanced bariatric, hernia and colon surgery. However, an important issue that remains to be defined is which training model (THC, anesthetized animals, virtual computer training, etc.) is the most appropriate for the curriculum of the skill or procedure that is being trained.

Keywords

Thiel human cadaver Eeducation Laparoscopic surgery Advanced laparoscopic procedures Colon Hernia Bariatric Vascular 

Abbreviations

EAES

European Association of Endoscopic Surgeons

LS

Likert scale

MIS

Minimal invasive surgery

SAGES

Society of American Gastrointestinal and Endoscopic Surgeons

SALTS

Swiss Association of Laparoscopic and Thoracoscopic Surgery

SETC

SwissEndos Training Centre

SD

Standard deviation

SSS

Swiss Society of Surgeons

TAPP

Transabdominal preperitoneal approach

TEP

Totally extraperitoneal approach

THC

Thiel human cadaver

Notes

Acknowledgement

We thank Christian Gerber, David Stucki, and Panayotis Petropoulos as founders of the SETC in Fribourg, Switzerland.

References

  1. 1.
    Mühe C (1986) Cholecystektomie durch das Laparoskop. Langenbecks Arch Klein Chir 369:804CrossRefGoogle Scholar
  2. 2.
    European Association of Endoscopic Surgeons (1994) Training and assessment of competence. Surg Endosc 8:721–722CrossRefGoogle Scholar
  3. 3.
    Society of American Gastrointestinal Endoscopic Surgeons. (1991) Granting of privileges for laparoscopic general surgery. Am J Surg 161:324–325CrossRefGoogle Scholar
  4. 4.
    Miko I, Furka I, Gamal EM, Metzger P, Sapy P (1997) Details of teaching, learning and training in laparoscopic surgery. Acta Chir Hung 36:230–232PubMedGoogle Scholar
  5. 5.
    Kirwan WO, Kaar TK, Waldron R (1991) Starting laparoscopic cholecystectomy-the pig as a training model. Ir J Med Sci 160:243–246PubMedCrossRefGoogle Scholar
  6. 6.
    Villegas L, Schneider BE, Callery MP, Jones DB (2003) Laparoscopic skills training. Surg Endosc 17:1879–1888PubMedCrossRefGoogle Scholar
  7. 7.
    Ali MR, Mowery B, Kaplan B, DeMaria J (2002) Training the novice in laparoscopy-More challenge is better. Surg Endosc 16:1732–1736PubMedCrossRefGoogle Scholar
  8. 8.
    Thiel W (1992) The preservation of the whole corps with natural colour. Ann Anat 174:185–195PubMedGoogle Scholar
  9. 9.
    Groscurth P, Eggli P, Kapfhammer J, Rager G, Hornung JP, Fasel JDH (2001) Gross Anatomy in the Surgical Curriculum in Switzerland: Improved Cadaver Preservation, Anatomical Models, and Course Develompent. New Anat 265:254–256CrossRefGoogle Scholar
  10. 10.
    Räder S, Hahnloser D, Clavien PA (2006) Is training of minimal invasive surgeons in Switzerland adequate? Swiss Knife (special edition) 2006:27. (Abstract)Google Scholar
  11. 11.
    Steinke W, Allemann F (2006) Future professional education in laparoscopic surgery as seen by the chief surgeons in Switzerland – A representative survey. Swiss Knife (special edition): 16. (Abstract)Google Scholar
  12. 12.
    Scott DJ, Bergen PC, Rege RV, Laycock R, Tesfay ST, Valentine RJ, et al. (2000) Laparoscopic training on bench models: Better and more cost effective than operating room experience? J Am Coll Surg 191:272–283PubMedCrossRefGoogle Scholar
  13. 13.
    Seymour NE, Gallagher AG, Roman SA, O`Brien MK, Bansal VK, Andersen DK, et al. (2002) Virtual reality training improves operating room performance: Results of a randomized, double-blinded study. Ann Surg 236:458–463PubMedCrossRefGoogle Scholar
  14. 14.
    von Segesser LK, Westaby St, Pomar J, Loisance D, Groscurth P, Turina M (1999) Less invasive aortic valve surgery: rationale and technique. Eur J Cardiothorac Surg 15:781–785CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Urs Giger
    • 1
    • 2
    • 4
  • Isabelle Frésard
    • 1
  • André Häfliger
    • 1
    • 2
  • Mathias Bergmann
    • 3
  • Lukas Krähenbühl
    • 1
    • 2
    • 4
  1. 1.Department of SurgeryHôpital Cantonal FribourgFribourgSwitzerland
  2. 2.Swiss Association of Laparoscopic and Thoracoscopic Surgery (SALTS)AarbergSwitzerland
  3. 3.Anatomy Department of MedicineUniversity of FribourgFribourgSwitzerland
  4. 4.Department of Visceral SurgeryLindenhofspital BerneBerneSwitzerland

Personalised recommendations