Skip to main content

Advertisement

SpringerLink
Log in

A surgical training system designed to help trainees acquire laparoscopic surgical skills at a rural Japanese institute

  • Original Article
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

The Endoscopic Surgical Skill Qualification System was established in Japan to evaluate safe endoscopic surgical techniques and teaching skills. Trainee surgeons obtaining this certification in rural hospitals are disadvantaged by the limited number of surgical opportunities. To address this problem, we established a surgical training system to educate trainee surgeons.

Methods

Eighteen certified expert surgeons affiliated with our department were classified into an experienced training system group (E group, n = 9) and a non-experienced group (NE group, n = 9). Results of the training system were then compared between the groups.

Results

The number of years required to become board certified was shorter in the E group (14 years) than that in the NE group (18 years). Likewise, the number of surgical procedures performed before certification was lower in the E group (n = 30) than that in the NE group (n = 50). An expert surgeon was involved in the creation of the certification video of all the E group participants. A questionnaire to board-certified surgeons revealed that guidance by a board-certified surgeon and trainee education (surgical training system) was useful for obtaining certification.

Conclusions

Continuous surgical training, starting with trainee surgeons, appears useful for expediting their acquisition of technical certification in rural areas.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Yamamoto S, Inomata M, Katayama H, Mizusawa J, Etoh T, Konishi F, et al. JCOG0404 short-term surgical outcomes from a randomized controlled trial to evaluate laparoscopic and open D3 dissection for stage II/III colon cancer: Japan Clinical Oncology Group Study JCOG 0404. Ann Surg. 2014;260:23–30.

    Article  PubMed  Google Scholar 

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

    Article  Google Scholar 

  3. Akagi T, Endo H, Inomata M, Yamamoto H, Mori T, Kojima K, et al. Clinical impact of Endoscopic Surgical Skill Qualification System (ESSQS) by Japan Society for Endoscopic Surgery (JSES) for laparoscopic distal gastrectomy and low anterior resection based on the National Clinical Database (NCD) registry. Ann Gastroenterol Surg. 2020;4:721–34.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Shibasaki S, Suda K, Nakauchi M, Nakamura K, Tanaka T, Kikuchi K, et al. Impact of the Endoscopic Surgical Skill Qualification System on the safety of laparoscopic gastrectomy for gastric cancer. Surg Endosc. 2021;35:6089–100.

    Article  PubMed  Google Scholar 

  5. Ichikawa N, Homma S, Funakoshi T, Ohshima T, Hirose K, Yamada K, et al. Impact of technically qualified surgeons on laparoscopic colorectal resection outcomes: results of a propensity score-matching analysis. BJS Open. 2020;4:486–98.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  6. Aoyama S, Inoue Y, Ohki T, Itabashi M, Yamamoto M. Usefulness of the endoscopic surgical skill qualification system in laparoscopic colorectal surgery: short-term outcomes: a single-center and retrospective analysis. BMC Surg. 2019;19:90.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Kapiteijn E, Kranenbarg EK, Steup WH, Taat CW, Rutten HJ, Wiggers T, et al. Total mesorectal excision (TME) with or without preoperative radiotherapy in the treatment of primary rectal cancer. Prospective randomised trial with standard operative and histopathological techniques. Dutch ColoRectal Cancer Group. Eur J Surg. 1999;165:410–20.

  8. Wang C, Gao Z, Shen K, Shen Z, Jiang K, Liang B, et al. Safety, quality and effect of complete mesocolic excision vs non-complete mesocolic excision in patients with colon cancer: a systemic review and meta-analysis. Colorectal Dis. 2017;19:962–72.

    Article  PubMed  CAS  Google Scholar 

  9. Detering R, Karthaus EG, Borstlap WAA, Marijnen CAM, van de Velde CJH, Bemelman WA, et al. Treatment and survival of locally recurrent rectal cancer: a cross-sectional population study 15 years after the Dutch TME trial. Eur J Surg Oncol. 2019;45:2059–69.

    Article  PubMed  Google Scholar 

  10. Nanashima A, Hidaka S, Nonaka T, Yamasaki N, Tsuchiya T, Matsumoto K, et al. Recruitment of Young Medical Apprentices (RYOMA) project: a comprehensive surgical education program at a local academic institute in Japan. J Surg Educ. 2014;71:587–92.

    Article  PubMed  Google Scholar 

  11. Tominaga T, Nonaka T, Fukuda A, Moriyama M, Oyama S, Ishii M, et al. Usefulness of structured-cadaveric training for trans-anal pelvic exenteration. Asian J Endosc Surg. 2022;15:299–305.

    Article  PubMed  Google Scholar 

  12. Sakai Y, Kitano S. Practice guidelines on endoscopic surgery for qualified surgeons by the Endoscopic Surgical Skill Qualification System. Asian J Endosc Surg. 2015;8:103–13.

    Article  PubMed  Google Scholar 

  13. Rossi I, Rossi M, McLaughlin E, Minor D, Smithson L, Borgstrom D, et al. Rural surgical training in the United States: delineating essential components within existing programs. Am Surg. 2020;86(11):1485–91.

    Article  PubMed  Google Scholar 

  14. Buunen M, Veldkamp R, Hop WC, Kuhry E, Jeekel J, Haglind E. Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. Lancet Oncol. 2009;10:44–52.

    Article  PubMed  Google Scholar 

  15. Chong A, Kiroff G. Preparing surgeons for rural Australia: the RACS Rural Surgical Training Program. ANZ J Surg. 2015;85:108–12.

    Article  PubMed  Google Scholar 

  16. Parker RK, Topazian HM, Parker AS, Mwachiro MM, Strain S, White RE, et al. Operative case volume minimums necessary for surgical training throughout rural Africa. World J Surg. 2020;44:3245–58.

    Article  PubMed  Google Scholar 

  17. Sekikawa K, Suzuki H, Sugiyama Y. Surgical skill training seminars for young doctors who belong to the multicenter–for the purpose of both regional cooperation and of eliminating the surgeon shortage. Nihon Geka Gakkai zasshi. 2012;113:257–62.

    PubMed  Google Scholar 

  18. Doty B, Heneghan S, Gold M, Bordley J, Dietz P, Finlayson S, et al. Is a broadly based surgical residency program more likely to place graduates in rural practice? World J Surg. 2006;30:2089–93.

    Article  PubMed  Google Scholar 

  19. Jarman BT, Cogbill TH, Mathiason MA, O’Heron CT, Foley EF, Martin RF, et al. Factors correlated with surgery resident choice to practice general surgery in a rural area. J Surg Educ. 2009;66:319–24.

    Article  PubMed  Google Scholar 

  20. Nakanishi R, Fukunaga Y, Mukai T, Nagasaki T, Yamaguchi T, Akiyoshi T, et al. Educational system for acquiring appropriate laparoscopic colorectal surgical skills: analysis in a Japanese high-volume cancer center. Surg Endosc. 2020. https://doi.org/10.1007/s00464-020-07686-2.

    Article  PubMed  Google Scholar 

  21. Katayama H, Tominaga T, Nonaka T, Wada H, To K, Hamada K, et al. Effect of endoscopic surgical skill qualification system for laparoscopic multivisceral resection: Japanese multicenter analysis. Surg Endosc. 2022;36:3068–75.

    Article  PubMed  Google Scholar 

  22. Shiraishi T, Tominaga T, Nonaka T, Hamada K, Araki M, Sumida Y, et al. A learning curve in using organ retractor for single-incision laparoscopic right colectomy. Sci Rep. 2021;11:6546.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

Download references

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan

    Tetsuro Tominaga, Takashi Nonaka, Yasumasa Hashimoto, Keiko Hamasaki, Jyunichi Arai, Keitaro Matsumoto, Terumitsu Sawai & Takeshi Nagayasu

Authors
  1. Tetsuro Tominaga
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Takashi Nonaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yasumasa Hashimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Keiko Hamasaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jyunichi Arai
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Keitaro Matsumoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Terumitsu Sawai
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Takeshi Nagayasu
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

TT was the main designer of the study. TT, TN, YH, KH, JA, and KM coordinated the training. TS and TN supervised the study. All the co-authors contributed substantially to this study and fulfilled the requirements for authorship as per the guidelines of the International Committee of Medical Journal Editors. All the authors have read and approved the final version of the manuscript.

Corresponding author

Correspondence to Tetsuro Tominaga.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest to declare.

Ethics approval

This study was performed in line with the principles of the 1964 Declaration of Helsinki and its later amendments. Approval was granted by the clinical research review boards of all participating hospitals.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tominaga, T., Nonaka, T., Hashimoto, Y. et al. A surgical training system designed to help trainees acquire laparoscopic surgical skills at a rural Japanese institute. Surg Today 54, 145–151 (2024). https://doi.org/10.1007/s00595-023-02713-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-023-02713-w

Keywords

Search

Navigation