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Considered Laparoscopic Surgery Techniques in Residency Training Programs

by Uneeb Khan
Laparoscopic Trainer
Laparoscopic Trainer

Impact On Health Care

The real possibility of scarce resources and economically and commercially blocked of being able to an expensive. But less invasive technology available in almost all its hospital centers. With which it performs completely free of charge. (Like all surgical interventions performed) to almost 100% of the patients who require a cholecystectomy. Laparoscopic Trainer.

For many reasons use of emulators is a practical choice like Laparoscopic Trainer.

Quality Of Surgical Care

This example alone is enough to measure the positive impact it has had on the quality of surgical care in these 13 years of work. If we keep in mind Gallbladder disorders are very frequent in our environment.

Effects Of Economic Situation

This economic situation affects health services and prevents this costly but less invasive technology from being available throughout the national territory. And 100% of patients requiring a cholecystectomy being able to receive it laparoscopically. Completely free of charge, as all surgical interventions performed. Laparoscopic Trainer.

Postgraduate Teaching

The improvement of the training model and the profile of the surgeon is a very frequent topic of debate worldwide. Because it is necessary to periodically modify the training programs of the residents in the different specialties.

Surgeon Professional Profile

To adapt them to the new realities that are taking place in the field of surgery and in society. In articles already publish that warn about the need to make changes to the professional profile of the surgeon. Laparoscopic Trainer.

Assimilation Of a Technology

The assimilation of a technology that has revolutionizes the specialty alone imposes changes. In its beginnings, worldwide, its incorporation into the study programs of the specialty delays because it overvalues. Follow as:

  • And it then classifies as grade V complexity surgery,
  • Compared with hepatic and pancreatic resection surgery,
  • And it establishes that their training carries out after completing the specialty.

Opportunity For Training

However, it already shows that laparoscopic surgery performs by residents if adequate programs create. And they give the opportunity to acquire the theoretical knowledge and practical skills necessary for it. In its own development has turned it into an obstacle for the comprehensive training of residents. Laparoscopic Trainer.

Includes In Study Program

Laparoscopic surgery not yet includes in the current study program. And it is our opinion that it includes immediately to adapt the program to the new realities. In addition, because certain situations are very common in the services that demonstrate by themselves. That the training of the residents and that of many of the specialists graduated in the last 10 years is not what requires. Since it has been interfering in the teaching-learning process.

Teaching Example

See an example below: After abdominal wall hernia surgery, cholecystectomy is the surgical intervention most frequently performed electively in general surgery services. If cases with specific contraindications excludes. All patients have the possibility of having the intervention performed laparoscopically. Since all teaching hospitals and some clinics have this technology.

Medical Career of Residents

Due to this, residents generally conclude their 4-year career without performing any laparoscopic cholecystectomy. And very few open elective cholecystectomies. So, they get only the opportunity to perform this intervention through the traditional route and in the emergency services during their medical guards. Laparoscopic Trainer.

Learning The Surgical Technique

This fact is clearly irrational and contradictory, because although supervised by a teacher, they began learning the surgical technique of biliary tract surgery. In the most difficult and complex cases (acute cases). And performed the dissection in an edematous and inflamed tissue that produces loss. Or distortion of the anatomy and like is logic where the risks of iatrogenesis are greater.

Techniques Of Minimally Invasive Surgery

But everything does not stay there. An increasing number of our hospitals are having the equipment. And incorporating the techniques of minimally invasive surgery in the emergency services. (Which performs by specialists trained in it). Then the resident not only sees his already meager aspirations of performing some cholecystectomies vanish. But even worse, it begins to observe how conditions as frequent and necessary for his learning as:

  • Acute appendicitis,
  • Perforated duodenal ulcer,
  • Among others,

Treats by surgeons trained in minimal access surgery.

Undoubtedly, the way it is happening, the technological development of the specialty becomes a clear setback for the quality of our future surgeons. With the aggravating circumstance that deficiencies in surgical techniques are more difficult to correct after graduation. Laparoscopic Trainer.

Considered Techniques In Study Programs

Most of the countries of the world and of the region itself, have contemplated these techniques in their study programs. The main differences exist in terms of the number of interventions to perform and in what year they perform.

Residency Training Program

If we evaluate two these contrasts and observe. Where the residency only lasts 3 years and even though the study commission itself for the residency training program. It recognizes that this period is still insufficient to train a resident and wishes in the future to extend it to 4 years. The proposal is that by the end of the specialty the resident has participated in at least 130 laparoscopic cholecystectomies (50 as main surgeon and 80 as assistant).

Specialization

The residency has a duration of 5 years and since 2003 laparoscopic surgery already includes in the specialization programs of some hospitals.  That dictated their own standards because they not define in the program. An example of this Hospital, where on that date at least 24 laparoscopic cholecystectomies performed as main surgeon requires at the end of the fifth year. These interventions begin in the third year of the residency and distributes.

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