Abstract
Background
Laparoscopy-assisted distal gastrectomy (LADG) for stomach cancer is increasingly performed in Japan and Korea. However, the procedure still is considered to be complicated, and the optimal education system for trainees has not been established to date.
Methods
The authors organized a 1-day professional training course termed the LADG Basic Lab Course for LADG beginners. The participants were required to apply as a team of two surgeons and two operating nurses. The training course consisted of lectures and a live porcine lab emphasizing use of the ultrasonically activated device and the flexible laparoscope as well as team cooperation. The quality and effectiveness of the course were evaluated 6–10 months (mean, 8.2 ± 2.2 months) after the course using a survey form sent to a representative surgeon of each institution.
Results
From May 2007 to July 2008, a total of 80 colleagues (47 surgeons and 33 nurses) from 20 different centers in Japan participated in the training course. These surgeons represented 12.4 ± 6.2 postgraduate years of education and had performed 2.7 ± 4.9 LADGs before taking the course. In the follow-up evaluation, 12 institutions (60%) completed the survey forms. The mean operation time was reduced for eight respondents (66.7%). The number of LADGs performed per month increased in 50% of the respondents’ institutions. The degree of lymph node dissection in LADG was extended for 66.7% of the respondents. The respondents answered that 100% of the first operators showed improvement in skills, as did 59.5% of the scope operators and 59.5% of the nurses.
Conclusions
The training course was an effective means of introducing LADG to each institution. Training courses emphasizing explanations of key devices and teamwork may be effective for the introduction of advanced laparoscopic surgeries.
Similar content being viewed by others
References
Japanese Society for Endoscopic Surgery (2008) Ninth Nationwide survey of endoscopic surgery in Japan. J Jpn Soc Endosc Surg 13:499–611
Hiki N, Fukunaga T, Yamaguchi T, Nunobe S, Tokunga M, Ohyama S, Seto Y, Yoshiba H, Nohara K, Inoue H, Muto T (2008) The benefits of standardizing the operative procedure for the assistant in laparoscopy-assisted gastrectomy for gastric cancer. Langenbecks Arch Surg 393:963–971
Tokunaga M, Hiki N, Fukunaga T, Miki A, Nunobe S, Ohyama S, Seto Y, Yamaguchi T (2009) Quality control and educational value of laparoscopy-assisted gastrectomy in a high-volume center. Surg Endosc 23:289–295
Uyama I, Sugioka A, Matsui H, Fujita J, Komori Y, Hasumi A (2000) Laparoscopic D2 lymph node dissection for advanced gastric cancer located in the middle or lower third portion of the stomach. Gastric Cancer 3:50–55
Catchpole K, Mishra A, Handa A, McCulloch P (2008) Teamwork and error in the operating room: analysis of skills and roles. Ann Surg 247:699–706
Undre S, Koutantji M, Sevdalis N, Gautama S, Selvapatt N, Williams S, Sains P, McCulloch P, Darzi A, Vincent C (2007) Multidisciplinary crisis simulations: the way forward for training surgical teams. World J Surg 31:1843–1853
Mishra A, Catchpole K, Dale T, McCulloch P (2008) The influence of nontechnical performance on technical outcome in laparoscopic cholecystectomy. Surg Endosc 22:68–73
Kanehira E, Kinoshita T, Omura K (1999) Ultrasonically activated devices for endoscopic surgery. Minim Invasive Ther Allied Technol 8:89–94
Kinoshita T, Kanehira E, Omura K, Kawakami K, Watanabe Y (1999) Experimental study on heat production by a 23.5-kHz ultrasonically activated device for endoscopic surgery. Surg Endosc 13:621–625
Kanehira E, Omura K, Kinoshita T, Kawakami K, Watanabe Y (1999) How secure are the arteries occluded by a newly developed ultrasonically activated device? Surg Endosc 13:340–342
Japanese Gastric Cancer Association (1998) Japanese classification of gastric carcinoma, 2nd English Edition. Gastric Cancer 1:10–24
Jin SH, Kim DY, Kim H, Jeong IH, Kim MW, Cho YK, Han SU (2007) Multidimensional learning curve in laparoscopy-assisted gastrectomy for early gastric cancer. Surg Endosc 21:28–33
Kim MC, Jung GJ, Kim HH (2005) Learning curve of laparoscopy-assisted distal gastrectomy with systemic lymphadenectomy for early gastric cancer. World J Gastroenterol 11:7508–7511
Kunisaki C, Makino H, Yamamoto N, Sato T, Oshima T, Nagano Y, Fujii S, Akiyama H, Otsuka Y, Ono HA, Kosaka T, Takagawa R, Shimada H (2008) Learning curve for laparoscopy-assisted distal gastrectomy with regional lymph node dissection for early gastric cancer. Surg Laparosc Endosc Percutan Tech 18:236–241
Tanimura S, Higashino M, Fukunaga Y, Kishida S, Nishikawa M, Ogata A, Osugi H (2005) Laparoscopic distal gastrectomy with regional lymph node dissection for gastric cancer. Surg Endosc 19:1177–1181
Halvorsen FH, Elle OJ, Fosse E (2005) Simulators in surgery. Minim Invasive Ther Allied Technol 14:214–223
Gonzalez R, Nelson LG, Murr MM (2007) Does establishing a bariatric surgery fellowship training program influence operative outcomes? Surg Endosc 21:109–114
Duchene DA, Moinzadeh A, Gill IS, Clayman RV, Winfield HN (2006) Survey of residency training in laparoscopic and robotic surgery. J Urol 176:2158–2166
Acknowledgments
The authors sincerely thank all members of the SP Sales Marketing Department, Olympus Medical Systems Corp., Tokyo, Japan, for their support and cooperation during this study. The authors also thank all the surgeons and nurses taking the course for their cooperation in this study.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kinoshita, T., Kanehira, E., Matsuda, M. et al. Effectiveness of a team participation training course for laparoscopy-assisted gastrectomy. Surg Endosc 24, 561–566 (2010). https://doi.org/10.1007/s00464-009-0607-z
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-009-0607-z