The effect of laparoscopy courses in laparoscopy practice after urology resident training: A questionnaire-based observational study

Abstract

Aim: Laparoscopy is an important part of surgical training. Laparoscopy courses are organized to increase competence of laparoscopy. This aim of this paper is to evaluate the laparoscopic surgery competence of Turkish urologists and the effectiveness of laparoscopy courses.

Methods: In 2014, an online survey consisting of 11 questions was sent to 180 urologists via e-mail, among which 78 responded. The survey questions aimed at gathering information about where the urologists worked, their laparoscopic surgical experience, how long they attended laparoscopy courses, and whether they considered themselves to be competent in laparoscopic surgeries.

Results: 41.2% of the respondents who considered themselves to be competent in laparoscopy and 84.1% of those who did not, stated that they wanted to attend laparoscopy courses (P<0.001). 100% of the respondents who could perform Level-1 laparoscopy surgeries stated that they did not consider themselves to be competent and wanted to receive laparoscopic training (P<0.001). 54.9% of those who did not receive laparoscopy training during their residency and 48.1% of those who received training during residency stated that they attended courses in the past. All respondents who attended long-term courses and 73.6% of those who attended short-term courses could perform laparoscopic surgeries (P<0.001). It was also determined those who attended long-term courses could perform complicated laparoscopic surgeries (P<0.001).

Conclusion: This study revealed that the courses contributed a lot to laparoscopic surgical competence after residency. The study stresses that if the urologists who did not receive laparoscopy training during their residency attend long-term courses, they can increase their competence in laparoscopy.

Keywords

• Laparoscopy,Course,Survey,Competence

Laparoskopi kurslarının üroloji asistan eğitimi sonrası laparoskopi uygulamalarına etkisi: Ankete dayalı gözlemsel çalışma

Öz

Amaç: Laparoskopi, cerrahi eğitimin önemli bir parçasıdır. Laparoskopi yeterliliğini arttırmak için laparoskopi kursları düzenlenmektedir. Bu yazıda Türk ürologların, laparoskopik cerrahi yeterliliği ve laparoskopi kurslarının etkinliğinin değerlendirilmesi planlandı.

Yöntemler: 2014 yılında Türkiye’de üroloji alanındaki 180 uzmana e-mail anket formu gönderildi. Sorulara yanıt veren 78 üroloji uzmanının, çalıştığı kurum, laparoskopik deneyimi, aldıkları laparoskopi kurs süresi ve laparoskopi cerrahisindeki yeterlilikleri 11 soruluk anket ile sorgulanmıştır.

Bulgular: Laparoskopi konusunda kendini yeterli gören uzmanların %41,2’si, yeterli görmeyenlerin %84,1’i kurs almak istediğini belirtti (P<0,001). Zorluk seviyesi 1 kabul edilen laparoskopi vakaları yapabilen uzmanların %100’ü kendini yeterli görmeyip, laparoskopi eğitimi almak istediğini belirtti (P<0,001). Asistanlığında laparoskopi eğitimi almayanların %54,9’u ve alanların %48,1’i kurs almış. Uzun süreli kurs alanların hepsi, kısa süreli kurs alanların %73,6’sı laparoskopi yapabiliyordu (P<0,001). Uzun süreli kurs alanlar daha zor vaka yapabildiği izlenmektedir (P<0,001).

Sonuç: Yapılan anketin sonucunda, asistanlık sonrası laparoskopik cerrahi yeterliliğinde kursların büyük yarar sağladığı görülmektedir. Asistanlığında laparoskopi eğitimi almayan ürologların, uzun süreli eğitim veren merkezlerde bulunması laparoskopi becerilerini arttıracağını düşünmekteyiz.

Anahtar Kelimeler

• Laparoskopi,Kurs,Anket,Yeterlilik

Kaynakça

1. 1. Lane BR, Gill IS. 7-Year oncological outcomes after laparoscopic and open partial nephrectomy. J Urol. 2010;183:473–9.
2. 2. McNeill SA, Tolley DA. Review laparoscopy in urology: indications and training. BJU Int. 2002;89:169–73.
3. 3. Shalhav AL, Dabagia MD, Wagner TT, Koch MO, Lingeman JE. Training postgraduate urologists in laparoscopic surgery: The current challenge. J Urol. 2002;167:2135–7.
4. 4. Kaynan AM, Lee KL, Winfield HN. Survey of urological laparoscopic practices in the state of California. J Urol. 2002;167:2380–6.
5. 5. Khan MN, Fayyad T, Cecil TD, Moran BJ. Laparoscopic versus open appendectomy: The risk of postoperative infectious complications. JSLS. 2007;11:363–7.
6. 6. Barnes RW. Surgical handicraft: teaching and learning surgical skills. Am J Surg. 1987;153:422–7.
7. 7. Gonzalez D, Carnahan H, Praamsma M, Dubrowski A. Control of laparoscopic instrument motion in an inanimate bench model: Implications for the training and the evaluation of technical skills. Appl Ergon. 2007;38:123–32.
8. 8. Kroeze SG, Mayer EK, Chopra S, Aggarwal R, Darzi A, Patel A. Assessment of laparoscopic suturing skills of urology residents: a pan-European study. Eur Urol. 2009;56:865–72.

9. 9. Bansal VK, Tamang T, Misra MC, Prakash P, Rajan K, Bhattacharjee HK, et al. suturing skills acquisition: a comparison between laparoscopy exposed and laparoscopy-naive surgeons. JSLS. 2012;16:623–31.
10. 10. Khan MH, Aslam MZ, McNeill A, Tang B, Nabi G. Transfer of Skills From Simulation Lab to Surgical Services: Impact of a Decade Long Laparoscopic Urology Surgical Course. J Surg Educ. 2019;76:591-9.
11. 11. Tunc L, Guven S, Gurbuz C, Gozen AS, Tuncel A, Saracoglu F, et al. Evaluation of applied laparoscopic urology course using validated checklist. JSLS. 2013;17:300-5.
12. 12. Frede T, Erdogru T, Zukosky D, Gulkesen H, Teber D, Rassweiler J. Comparison of training modalities for performing laparoscopic radical prostatectomy: Experience with 1,000 patients. J Urol. 2005;174:673–8.
13. 13. Hruza M, Weiss HO, Pini G, Goezen AS, Schulze M, Teber D, Rassweiler JJ. Complications in 2200 consecutive laparoscopic radical prostatectomies: standardised evaluation and analysis of learning curves. Eur Urol. 2010;58:733–41.
14. 14. Burke LA, Baldwin TT. Workforce training transfer: a study of the effect of relapse prevention training and transfer climate. Hum Resour Manage. 1999;38:227–41.
15. 15. Furriel FT, Laguna MP, Figueiredo AJ, Nunes PT, Rassweiler JJ. Training of European urology residents in laparoscopy: results of a pan-European survey. BJU Int. 2013;112(8):1223-8.
16. 16. Ehdaie B, Tracy C, Reynolds C, Cung B, Thomas K, Floyd T, et al. Evaluation of laparoscopic curricula in American urology residency training. J Endourol. 2011;25:1805-10.
17. 17. Brinkman WM, Tjiam IM, Schout BM, Muijtjens AM, Van Cleynenbreugel B, Koldewijn EL, et al. Results of the European basic laparoscopic urological skills examination. Eur Urol. 2014;65:490-6.
18. 18. Castillo R, Buckel E, León F, Varas J, Alvarado J, Achurra P, Aggarwal R, et al. Effectiveness of learning advanced laparoscopic skills in a brief intensive laparoscopy training program. J Surg Educ. 2015;72:648-53.
19. 19. Asano TK, Soto C, Poulin EC, Mamazza J, Boushey RP. Assessing the impact of a 2-day laparoscopic intestinal workshop. Can J Surg. 2011;54:223–6.
20. 20. Okrainec A, Smith L, Azzie G. Surgical simulation in Africa: the feasibility and impact of a 3-day fundamentals of laparoscopic surgery course. Surg Endosc. 2009;23:2493–8.
21. 21. Dominguez EP, Barrat C, Shaffer L, Gruner R, Whisler D, Taylor P. Minimally invasive surgery adoption into an established surgical practice: impact of a fellowship trained colleague. Surg Endosc. 2013;27:1267–72.
22. 22. Kolla SB, Gamboa AJ, Li R, Santos RT, Gan JM, Shell C, et al. Impact of a laparoscopic renal surgery mini-fellowship program on postgraduate urologist practice patterns at 3-year follow-up. J Urol. 2010;184:2089–93.