Surgical endoscopy
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Laparoscopic liver resection has not been widely used because of intraoperative bleeding. This problem should be solved with instruments and techniques that require a short learning curve. ⋯ The technique used in our center is a safe, fast, and effective approach to laparoscopic liver resection. Our 14 years of experience demonstrates that this technique can prevent postoperative bleeding and bile leakage. A surgeon can master the skill of laparoscopic left hemihepatectomy, left lateral hepatectomy, non-anatomic liver resection, and segmentectomy after ∼15-30, 43, 35, and 28 case procedures, respectively.
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Randomized Controlled Trial Comparative Study
A prospective, randomized study comparing minilaparotomy and laparoscopic cholecystectomy as a day-surgery procedure: 5-year outcome.
The long-term outcome between laparoscopic cholecystectomy (LC) and minilaparotomy (MC) has not been compared in randomised trials as day-surgery procedures. We therefore investigated the outcome after day-case LC and MC in 48 patients. ⋯ Day-case MC and LC patients have a quite similar long-term outcome with no significant difference regarding residual abdominal symptoms, cosmetic satisfaction, QoL, or CPSP.
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Randomized Controlled Trial
Tailored instructor feedback leads to more effective virtual-reality laparoscopic training.
Laparoscopic novices begin at different performance levels, and studies on tailored training concepts are warranted. The effect of verbal instructor feedback has been investigated with varying results, and its effectiveness in virtual-reality laparoscopic (VRL) simulations still is unclear. This study aimed to determine whether laparoscopic novices with lower initial performance statuses may profit from training with intensive instructor feedback. ⋯ This is the first study to use a tailored training concept with instructor feedback limited to the LPG. The tailored training was effective and economic for the laparoscopic novices and their teachers.
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Randomized Controlled Trial Comparative Study
Totally extraperitoneal repair under general anesthesia versus Lichtenstein repair under local anesthesia for unilateral inguinal hernia: a prospective randomized controlled trial.
Lichtenstein repair (preferably under local anesthesia) or totally extraperitoneal repair (TEP) are both good options for treating uncomplicated unilateral inguinal hernia. We performed a prospective randomized trial to compare the outcome of TEP repair under general anesthesia versus open Lichtenstein inguinal hernioplasty under local anesthesia. ⋯ Lichtenstein repair under local anesthesia is as good as TEP under general anesthesia. The shorter operating room time, smaller mesh size, and lower cost of local anesthetic drugs all contribute to make Lichtenstein repair the better choice for repair of uncomplicated unilateral inguinal hernia, especially in developing nations with scarce resources.
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Randomized Controlled Trial
Randomized controlled trial on the effect of coaching in simulated laparoscopic training.
The effect of coaching on surgical quality and understanding in simulated training remains unknown. The aim of this study was compare the effects of structured coaching and autodidactic training in simulated laparoscopic surgery. ⋯ Clinically relevant markers of proficiency including error reduction, understanding of surgical strategy, and surgical quality are significantly improved with structured coaching. Path length and number of movements representing merely manual skills are developed with task repetition rather than influenced by coaching. Structured coaching may represent a key component in the acquisition of procedural skills.