Page 33 - Jourmal of World Association of Laparoscopic Surgeon
P. 33
WJOLS
A Review of Medical Education in Minimally Invasive Surgery
DISCUSSION REFERENCES
Although these systems (laparoscopy and robotics) may 1. Weiser TG, Regenbogen SE, Thompson KD, Haynes AB,
seem to be inherently different they share some similarities. Lipsitz SR, Berry WR, et al. An estimation of the global volume
They are both newer areas of surgery than conventional of surgery: A modeling strategy based on available data. The
Lancet 2008 Jul;372(9633):139-44.
surgery. Moreover, they are growing areas of surgery with 2. Keshavarz H, Hillis SD, Kieke BA, Marchbanks PA.
more and more surgeons desiring to be educated in these Hysterectomy Surveillance—United States, 1994-1999. MMWR
modalities. Medical education in laparoscopy and robotics 2002 Jul;51(SS05):1-8. Available from: http://www.cdc.gov/
are both areas of current interest. mmwr/preview/mmwrhtml/ss5105a1.htm.
Several studies agree that simulation training used as 3. Catenacci M, Flyckt RL, Falcone T. Robotics in reproductive
an adjunct to traditional training methods to equip the next surgery: Strengths and limitations. Placenta 2011 Sep;32(3):
S232-37.
generation of laparoscopic and robotic surgeons with the 4. Chapron C, Fauconnier A, Goffinet F, Bréart G, Dubuisson JB.
skills required to operate proficiently and safely. Several Laparoscopic surgery is not inherently dangerous for patients
valid and reliable monitoring tools for laparoscopic surgical presenting with benign gynaecologic pathology. Results of a
training have been implemented successfully into various meta-analysis. Hum Reprod 2002;17(5):1334-42.
surgical training programs. 5. Kaul S, Shah NL, Menon M. Learning curve using robotic
surgery. Current Urol Rep 2006 Mar;7(2):125-29.
The development of laparoscopy has been driven by the 6. Zerey M, Adrales GL, Kercher KW. Learning curve in
surgeons; whereas robotic education is currently industry laparoscopic surgery. Minimally invasive surgery training:
driven. Curriculum for laparoscopy has been developed and Theories, models, outcomes. A National Institute of Health and
is being implemented in many surgical training programs. National Library of Medicine.
However, current simulation models have only been 7. Raja R, Mishra RK. The impact of the learning curve
in laparoscopic surgery. Available from: http://www.
validated in small studies. There is no evidence to suggest laparoscopyhospital.com.
one type of simulator provides more effective training than 8. Lenihan J Jr, Kovanda C, Seshadri-Kreaden U. What is the
any other. learning curve for robotic assisted gynecologic surgery? J Minim
In robotics, simulation has been validated for certain Invasive Gynecol 2008;15(5):589-94.
aspects of education. However, more research is needed to 9. Roberts KE, Bell RL, Duffy AJ. Evolution of surgical skills
training. World J Gastroenterol 2006 May 28;12(20):3219-24.
validate simulated environments further and investigate the 10. Semm DK. Operative manual for endoscopic abdominal surgery.
effectiveness of animal and cadaveric training in robotic Operative Pelviscopy. Chicago, London: Year Book Medical
surgery. However, the effectiveness of animal and cadaveric Publishers Inc 1987:5-15.
workshops has been validated in laparoscopy. Some of the 11. Reichert JA, Valle RF. Fitz-Hugh-Curtis syndrome. A laparos-
current limitations in robotic surgical education include the copic approach. JAMA 1976;236:266-68.
cost, the availability of training centers, and the need to 12. Westebring-van der Putten EP, Goossens RHM, Jakimowicz JJ,
Dankelman J. Haptics in minimally invasive surgery-A review.
educate the operating room nursing staff. Minimally Invasive Ther Allied Technol 2008;17(1):3-16.
13. Chen CC, Falcone T. Robotic gynecologic surgery: Past, present
CONCLUSION and future. Clin Obstet Gynecol 2009 Sep;52(3):335-43.
14. Surgical. Available from: http://www.intuitivesurgical.com.
There are many similarities between the education in Accessed 10/24/2012.
laparoscopy and robotic surgery including the need for 15. Heinrichs WL, Srivastava S, Pugh C, et al. Visual language to
medical education, the need for continued development of interface users of educational surgical simulators for fundamental
curriculum and the need for continued advancement in surgical manipulations. In: Proceedings of 14th Annual
technologies. Given the known benefits of these surgical International Meeting of Computer-assisted Radiology and
Surgery (CARS). Lemke HJ, (Ed). San Francisco, Amsterdam:
modalities, there is continued need for research and Elsevier Publishers; 2000;29-34.
advancing training programs in laparoscopy and training 16. Satava RM, Cuschieri A, Hamdorf J. Metrics for objective
in robotic surgery and programs for safe and effective integ- assessment of surgical skills workshop. Surg Endosc 2003;17(2):
ration of these modalities into the surgical subspecialties. 220-26.
17. Fried GM, DeRossis AM, Bothwell J, Sigman HH. Comparison
of laparoscopic performance in vivo with performance in a
ACKNOWLEDGMENTS
laparoscopic simulator. Surg Endosc 1999;13:1077-81.
The author acknowledges Dr Mishra and Dr Cohwen and 18. Grantcharov TP, Rosenberg J, Pahle P, Funch-Jensen P. Virtual
the entire staff of the World Laparoscopy Hospital. She reality computer simulation. Surg Endosc 2001;15(3):242-44.
would also like to acknowledge her colleague Rodrigo 19. Seymour NE, Gallagher AG, Roman SA, et al. Virtual reality
performance improves operating room performance: Results
Molina and Princess Margaret Library, Nassau, Bahamas of a randomized, double-blinded trial. Ann Surg 2002;236:
for their support during this article. 458-64.
World Journal of Laparoscopic Surgery, January-April 2013;6(1):33-36 35