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Comprehension of fundamental knowledge about pediatric endoscopic surgery: a cross-sectional study in Japan

  • 2023 SAGES Oral
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Pediatric endoscopic surgery has become an alternative to conventional techniques with the development of medical equipment. However, there is no formal, standardized curriculum for pediatric endoscopic surgery, and its requirement remains elusive. The purpose of this study is to determine the baseline knowledge of pediatric surgeons that is considered essential for pediatric laparoscopic and thoracoscopic surgery.

Methods

Sixteen web-based multiple-choice questions based on the fundamental cognitive knowledge of pediatric endoscopic surgery were administered. The questions were created based on the fields covered by the Fundamentals of Laparoscopic Surgery ™ (FLS) certification examination blueprints and eight specific diseases of pediatric surgery. Pediatric surgeons and pediatric surgical trainees participated in this study voluntarily.

Results

A total of 122 surgeons participated through the Japanese Society of Pediatric Surgeons. The response rate was 95% (122/128). The total mean examination score of all participants was 79.4% (77.3–81.4%). There were no significant differences in total scores between the board-certified pediatric surgeons without an endoscopic surgical skill qualification and the non-board-certified pediatric surgeons (80.4% vs. 77.1%, p = 0.12). The endoscopic surgical skill-qualified surgeons had significantly higher percentages of correct responses in specific subjects than board-certified pediatric surgeons and surgeons without pediatric board certification (94.3% vs. 82.9%, p = 0.02; 94.3% vs. 77.5%, p = 0.0002). The FLS original subjects’ scores were not significantly different among them. The mean score of surgeons who had experienced more than 200 cases of endoscopic surgery, including adult cases, was 83.2% (80.4–85.9%).

Conclusions

A knowledge gap exists between surgeons, board-certified pediatric surgeons, and endoscopic surgical skill-qualified surgeons in Japan. In the field of pediatric surgery, an effective formal curriculum, such as FLS, is required to help address this vast knowledge gap for the safe conduct of endoscopic surgeries.

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References

  1. Fox D, Morrato E, Campagna EJ, Rees DI, Dickinson LM, Partrick DA, Kempe A (2011) Outcomes of laparoscopic versus open fundoplication in children’s hospitals: 2005–2008. Pediatrics 127:872–880. https://doi.org/10.1542/peds.2010-1198

    Article  PubMed  PubMed Central  Google Scholar 

  2. Kalfa N, Allal H, Raux O, Lardy H, Varlet F, Reinberg O, Podevin G, Héloury Y, Becmeur F, Talon I, Harper L, Vergnes P, Forgues D, Lopez M, Guibal M-P, Galifer R-B (2007) Multicentric assessment of the safety of neonatal videosurgery. Surg Endosc 21:303–308. https://doi.org/10.1007/s00464-006-0044-1

    Article  PubMed  Google Scholar 

  3. Bishay M, Giacomello L, Retrosi G, Thyoka M, Garriboli M, Brierley J, Harding L, Scuplak S, Cross KM, Curry JI, Kiely EM, Coppi PD, Eaton S, Pierro A (2013) Hypercapnia and acidosis during open and thoracoscopic repair of congenital diaphragmatic hernia and esophageal atresia: results of a pilot randomized controlled trial. Ann Surg 258:895–900. https://doi.org/10.1097/SLA.0b013e31828fab55

    Article  PubMed  Google Scholar 

  4. Yokoyama S, Mizunuma K, Kurashima Y, Watanabe Y, Mizota T, Poudel S, Kikuchi T, Kawai F, Shichinohe T, Hirano S (2019) Evaluation methods and impact of simulation-based training in pediatric surgery: a systematic review. Pediatr Surg Int 35:1085–1094. https://doi.org/10.1007/s00383-019-04539-5

    Article  PubMed  Google Scholar 

  5. Patel EA, Aydın A, Desai A, Dasgupta P, Ahmed K (2019) Current status of simulation-based training in pediatric surgery: A systematic review. J Pediatr Sur 54:1884–1893. https://doi.org/10.1016/j.jpedsurg.2018.11.019

    Article  Google Scholar 

  6. Brunt LM (2014) FLS: celebrating a decade of innovation in surgical education. Bulletin of the American College of Surgeons. http://bulletin.facs.org/2014/11/fls-celebrating-a-decade-of-innovation-in-surgical-education/#.Wr7zVWbAOnc. Accessed 19 May 2022.

  7. Bilgic E, Kaneva P, Okarinec A, Ritter EM, Schwaitzberg SD, Vassiliou MC (2018) Trends in the Fundamentals of Laparoscopic Surgery® (FLS) certification exam over the past 9 years. Surg Endosc 32:2101–2105. https://doi.org/10.1007/s00464-017-5907-0

    Article  PubMed  Google Scholar 

  8. Derevianko AY, Schwaitzberg SD, Tsuda S, Barrios L, Brooks DC, Callery MP, Fobert D, Irias N, Rattner DW, Jones DB (2010) Malpractice carrier underwrites fundamentals of laparoscopic surgery training and testing: a benchmark for patient safety. Surg Endosc 24:616–623. https://doi.org/10.1007/s00464-009-0617-x

    Article  PubMed  Google Scholar 

  9. Hafford ML, Van Sickle KR, Willis RE, Wilson TD, Gugliuzza K, Brown KM, Scott DJ (2013) Ensuring competency: are fundamentals of laparoscopic surgery training and certification necessary for practicing surgeons and operating room personnel? Surg Endosc 27:118–126. https://doi.org/10.1007/s00464-012-2437-7

    Article  PubMed  Google Scholar 

  10. Watkins R, West-Meiers M, Visser Y (2012) A guide to assessing needs: Tools for collecting information, making decisions, and achieving development results. World Bank, Washington, DC

    Book  Google Scholar 

  11. Mori T, Kimura T, Kitajima M (2010) Skill accreditation system for laparoscopic gastroenterologic surgeons in Japan. Minim Invasive Ther Allied Technol 19:18–23

    Article  PubMed  Google Scholar 

  12. Japanese congenital diaphragmatic hernias guidelines. https://www.med-amc.com/jcs_society/images/guideline/shouni2019.pdf Accessed 14 May 2022.

  13. Japan Society for Endoscopic Surgery. https://www.jses.or.jp/uploads/files/gijutsunintei/kisoku20211202.pdf. Accessed 14 May 2022.

  14. Shiroshita H, Inomata M, Akira S, Kanayama H, Yamaguchi S, Eguchi S, Wada N, Kurokawa Y, Uchida H, Seki Y, Ieiri S, Iwazaki M, Sato Y, Kitamura K, Tabata M, Mimata H, Takahashi H, Uemura T, Akagi T, Taniguchi F, Miyajima A, Hashizume M, Matsumoto S, Kitano S, Watanabe M, Sakai Y (2021) Current Status of endoscopic surgery in Japan: the 15th national survey of endoscopic surgery by the japan society for endoscopic surgery. Asian J Endosc Surg 2021:1–12. https://doi.org/10.1111/ases.13012

    Article  Google Scholar 

  15. Yeo H, Viola K, Berg D, Lin Z, Smith MN, Cammann C, Bell RH Jr, Sosa JA, Krumholz HM, Curry LA (2009) Attitudes, training experiences, and professional expectations of US general surgery residents: a national survey. JAMA 302:1301–1308. https://doi.org/10.1001/jama.2009.1386

    Article  CAS  PubMed  Google Scholar 

  16. Dawe SR, Pena GN, Windsor JA, Broeders JAJL, Cregan PC, Hewett PJ, Maddern GJ (2014) Systematic review of skills transfer after surgical simulation-based training. Br J Surg 101:1063–1076. https://doi.org/10.1002/bjs.9482

    Article  CAS  PubMed  Google Scholar 

  17. Kirkpatrick D (1996) Great ideas revisited. Techniques for evaluating training programs. Revisiting Kirkpatrick’s Four-Level Model Train Dev 50:54–59

    Google Scholar 

  18. Nakajima K, Wasa M, Takiguchi S, Taniguchi E, Soh H, Ohashi S, Okada A (2003) A modular laparoscopic training program for pediatric surgeons. JSLS 7:33–37

    PubMed  PubMed Central  Google Scholar 

  19. Ieiri S, Nakatsuji T, Higashi M, Akiyoshi J, Uemura M, Konishi K, Onimaru M, Ohuchida K, Hong J, Tomikawa M, Tanoue K, Hashizume M, Taguchi T (2010) Effectiveness of basic endoscopic surgical skill training for pediatric surgeons. Pediatr Surg Int 26:947–954. https://doi.org/10.1007/s00383-010-2665-7

    Article  PubMed  Google Scholar 

  20. Jimbo T, Ieiri S, Obata S, Uemura M, Souzaki R, Matsuoka N, Katayama T, Masumoto K, Hashizume M, Taguchi T (2015) Effectiveness of short-term endoscopic surgical skill training for young pediatric surgeons: a validation study using the laparoscopic fundoplication simulator. Pediatr Surg Int 31:963–969. https://doi.org/10.1007/s00383-015-3776-y

    Article  PubMed  Google Scholar 

  21. Breaud J, Talon I, Fourcade L, Podevin G, Rod J, Audry G, Dohin B, Lecompte JF, Bensaid R, Rampal V, Azzie G (2019) The national pediatric surgery simulation program in France: a tool to develop resident training in pediatric surgery. J Pediatr Sur 54:582–586. https://doi.org/10.1016/j.jpedsurg.2018.09.003

    Article  Google Scholar 

  22. Barsness KA (2015) Trends in technical and team simulations: Challenging the status Quo of surgical training. Semin Pediatr Surg 24:130–133. https://doi.org/10.1053/j.sempedsurg.2015.02.011

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors would like to thank the members of the Japanese Society of Pediatric Surgeons and the participant institutes of Kagoshima University, Nagoya University Graduate School of Medicine, Kobe University Graduate School of Medicine, Kyushu University, Saitama Children’s Medical Center, Juntendo University School of Medicine, Osaka University Graduate School of Medicine, The University of Tokyo Hospital, Kyoto prefectural university of medicine, Niigata University Graduate School of Medical and Dental Sciences, Hokkaido Medical Center for Child Health and Rehabilitation, Kitano Hospital, Hokkaido University Graduate School of Medicine, Kagawa University, Tokai University School of Medicine, Nagasaki University Graduate School, Asahikawa Medical University, Mie university hospital, Iwate Medical University School of Medicine, Ehime university hospital, Osaka women’s and children’s hospital, Nara medical university, National Hospital Organization Kokura Medical Center, University of the Ryukyus faculty of medicine and university hospital, University of Tsukuba, Kindai University Nara Hospital, and Fukuoka children’s hospital. We could not have completed the survey study without their support.

Funding

This research received no specific grant from any funding agency.

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Authors and Affiliations

  1. Faculty of Medicine, Department of Gastroenterological Surgery II, Hokkaido University, Kita 15, Nishi 7, Kita-Ku, Sapporo, 060-8638, Japan

    Shinichiro Yokoyama, Yo Kurashima & Satoshi Hirano

  2. Department of Pediatric Surgery, Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo, Japan

    Shinichiro Yokoyama

  3. Clinical Simulation Center, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Yo Kurashima

  4. Department of Pediatric Surgery, Medical and Dental Sciences Area, Research and Education Assembly, Research Field in Medicine and Health Sciences, Kagoshima University, Kagoshima, Japan

    Satoshi Ieiri

  5. Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan

    Atsuyuki Yamataka

  6. Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan

    Hiroomi Okuyama

  7. Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Hiroo Uchida

  8. Division of Pediatric Surgery, Saitama Children’s Medical Center, Saitama, Japan

    Tetsuya Ishimaru

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  1. Shinichiro Yokoyama
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Correspondence to Yo Kurashima.

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Drs. Shinichiro Yokoyama, Yo Kurashima, Satoshi Ieiri, Atsuyuki Yamataka, Hiroomi Okuyama, Hiroo Uchida, Tetsuya Ishimaru, and Satoshi Hirano have no conflicts of interest or financial ties to disclose.

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Yokoyama, S., Kurashima, Y., Ieiri, S. et al. Comprehension of fundamental knowledge about pediatric endoscopic surgery: a cross-sectional study in Japan. Surg Endosc 37, 6408–6416 (2023). https://doi.org/10.1007/s00464-023-09975-y

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  • DOI: https://doi.org/10.1007/s00464-023-09975-y

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