Summary
The learning curve for laparoscopic herniorrhaphy (LH) is relatively long. Resident training is ideal for the acquisition of operative skills and yet intensive feedback is necessary for more complex procedures. A method whereby faculty provide objective and specific feedback for the technical details of operative LH is described. First a pretest focusing on important aspects of LH and relevant anatomy is given to the resident the day prior to the procedure. Immediately following the operation, the faculty and resident complete an evaluation form together to stimulate discussion and provide constructive feedback. This method of teaching is especially applicable at the resident training level but can be utilized by postgraduate surgeons willing to undergo the criticisms associated with objective operative feedback. Instant operative feedback is beneficial for all including the faculty member who by necessity is forced to communicate in specific terms the operative steps leading to the safe and effective conduct of LH.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Atabek U, Spence RK, Pello MJ, Alexander JB, Villanueva D, Camishion RC (1993) Safety of teaching laparoscopic cholecystectomy to surgical residents. J Laparoendosc Surg 3: 23–26
Bailey RW, Imbembo AL, Zucker KA (1991) Establishment of a laparoscopic cholecystectomy training program. Am Surg 57:231–236
Cundiff GW (1997) Analysis of the effectiveness of an endoscopy education program in improving residents» laparoscopic skills. Obstet Gynecol 90: 854–859
Edwards JC, Plauche WC, Marier RL (1988) Handbook of conferences on teaching skills for residents. Lawrence Erlbaum associates, Hillsdale, pp 21–28
Eldar S, Kunin J, Chouri H, Sabo E, Matter I, Nash E, Schein M (1996) Safety of laparoscopic cholecystectomy on a teaching service: a prospective trial. Surg Laparosc Endosc 6: 218–220
Ende J (1983) Feedback in clinical medical education. JAMA 250: 777–781
Ferzli G, Kiel T (1995) Evolving techniques in endoscopic extraperitoneal herniorrhaphy. Surg Endosc 9: 928–930
Friedman RL, Pace BW (1996) Resident education in laparoscopic cholecystectomy. Surg Endosc 10: 26–28
Halsted WS (1904) The training of the surgeon. Johns Hopkins Hosp Bull 15: 267–275
Hodgson WJB, Byrne DW, Savino JA, Liberis G (1994) Laparoscopic cholecystectomy: the early experience of surgical attendings compared with that of residents trained by apprenticeship. Surg Endosc 8: 1058–1062
Kald A, Anderberg B, Smedh K, Karlsson M (1977) Transperitoneal or totally extraperitoneal approach in laparoscopic hernia repair: results of 491 consecutive herniorrhaphies. Surg Laparosc Endosc 7: 86–89
Lekawa M, Shapiro SJ, Gordon LA, Rothbart J, Hiatt JR (1995) The laparoscopic learning curve. Surg Laparosc Endosc 5: 455–458
Lowham AS, Filipi CJ, Fitzgibbons Jr., RJ, Stoppa R, Wantz GE, Felix EL, Crafton WB (1997) Mechanisms of hernia recurrence after preperitoneal mesh repair. Ann Surg 225: 422–431
Mason GR (1986) The history of the development of surgical residencies in the United States. Prob Gen Surg 3: 355–367
Miller RE, Kimmelstiel FM (1992) Surgical laparoscopic experience during the first year on a teaching service. Surg Gynecol Obstet 175: 523–527
Quattlebaum TG (1996) Techniques for evaluating residents and residency programs. Pediatrics 98: 1277–1283
Quilici PJ, Greaney EM, Quilici J, Anderson S (1996) Transabdominal preperitoneal laparoscopic inguinal herniorrhaphy: results of 509 repairs. Am Surg 62: 849–852
SAGES residency integration sub-committee (1998) Proposals for training residents with a concentration in laparoscopic and endoscopic surgery. p. 1–2
SAGES resident education committee (1997–8) Curriculum guide for resident education in GI surgical endoscopy. p. 12,13,16
Sammarco MJ, Youngblood JP (1993) A resident teaching program in operative endoscopy. Obstet Gynecol 81: 463–466
Sloan DA, Donnelly MB, Schwartz RW, Felts JL, Blue AV, Strodel WE (1996) The use of the objective structured clinical examination (OSCE) for evaluation and instruction in graduate medical education. J Surg Res 63: 225–230
Swanstrom LL (1996) Laparoscopic herniorrhaphy. Surg Clin N Am 76: 483–491
Tsang SM, Caluda MJ, Steinberg SM, McSwain NE, Flint LM, Ferrara JJ (1994) Laparoscopic cholecystectomy: what's so special? South Med J 87: 1076–1082
Wolverton SE, Bosworth MF (1985) A survey of resident perceptions of effective teaching behaviors. Fam Med 17: 106–108
Zaraca F, Catarci M, Gossetti F, Carboni M (1995) Senior versus proctored young and resident surgeons' experience in laparoscopic cholecystectomy: is there any need of previous exposure to open biliary surgery? J Laparoendosc Surg 5:303–307
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Houghton, S.G., Filipi, C.J. A suggested method for laparoscopic herniorrhaphy resident training. Hernia 2, 193–197 (1998). https://doi.org/10.1007/BF01569145
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01569145