| Entrenamiento en un biosimulador y su impacto sobre la destreza en colecistectomia laparoscopica. |
| Flores-Gama F., Ramirez-Solis E., Lara-Ontiveros J., Aragon-Inclan J., Carmona-Moreno E., Soto-Sanchez B., |
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| Departamento de Cirugia General, Hospital General Dr. Manuel Gea Gonzalez, Secretaria de Salud, Calz. Tlalpan 4800, Col. Toriello Guerra, Deleg. Tlalpan, 14000 Mexico, D.F., Mexico. khanscrew@hotmail.com |
| OBJECTIVE: We undertook this study to determinate the educational impact of training in an inanimate biosimulator in terms of effectiveness, time and complications in performing laparoscopic cholecystectomy. METHODS: We used a comparative, experimental cohort, prospective and longitudinal. Three first-postgraduate-year residents and one pre-grade internship physician were trained and assessed in basic laparoscopic skills using a biosimulator (fiberglass "dummy" where animal organs are introduced ex-vivo). The participants acted as their own control, performing a procedure to determine surgical time, complications and effectiveness. Later they observed a short video demonstrating the suitable development of laparoscopic cholecystectomy. The video defined the specific deviations from the ideal cholecystectomy, which were considered as errors. Every procedure was videotaped, beginning with the careful dissection of cystic structures and clipping them, continuing with the dissection of the gallbladder from the liver with the standardized method. Each participant performed ten procedures. RESULTS: There were no differences in baseline assessment of basic skills. All participants completed all proposed procedures. Surgical time was 61% faster at the end of the study (p<0.001), as well as demonstrating a lower rate of complications of 0.67% (p<0.009). CONCLUSIONS: Skills training in endoscopic surgery by means of an inanimate biosimulator is superior to traditional training because it decreases surgical time and surgical complications without ethical considerations and the effect of a learning curve in the operating room. |
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