Surgical endoscopy
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The Texas Association of Surgical Skills Laboratories (TASSL) is a nonprofit consortium of surgical skills training centers for the accredited surgery residency programs in Texas. A training and research collaborative was forged between TASSL members and Simbionix (Cleveland, OH, USA) to assess the feasibility and efficacy of a multicenter, simulation- and Web-based flexible endoscopy training curriculum using shared GI Mentor II systems. ⋯ The feasibility of sharing educational and training resources among institutions was demonstrated. Likewise, the concept of "mobile simulation" appears to be useful and effective, with three of the four institutions involved successfully in implementing the training curriculum during a fixed period. Additionally, subjects who completed the training demonstrated both subjective and objective improvements in flexible endoscopy skills.
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Multicenter Study
Evaluation of surgical performance during laparoscopic incisional hernia repair: a multicenter study.
Laparoscopic incisional hernia repair (LIHR) is a common procedure requiring advanced laparoscopic skills. This study aimed to develop a procedure-specific tool to assess the performance of LIHR and to evaluate its reliability and validity. ⋯ Surgical performance during clinical LIHR can be assessed reliably using GOALS-IH. Results can be used to provide formative feedback to the surgeon and to identify steps of the operation that would benefit from specific educational interventions.
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Randomized Controlled Trial Multicenter Study Comparative Study
Laparoscopic versus open sigmoid resection for diverticular disease: follow-up assessment of the randomized control Sigma trial.
The short-term results of the Sigma trial show that laparoscopic sigmoid resection (LSR) used electively for diverticular disease offers advantages over open sigmoid resection (OSR). This study aimed to compare the overall mortality and morbidity rates after evaluation of the clinical outcomes at the 6-month follow-up evaluation. ⋯ The late clinical outcomes did not differ between LSR and OSR during the 30-day to 6-month follow-up period. Consideration of total postoperative morbidity shows a 27% reduction in major morbidity for patients undergoing laparoscopic surgery for diverticular disease.
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Multicenter Study Clinical Trial
Perioperative clinical outcomes after robotic thyroidectomy for thyroid carcinoma: a multicenter study.
Robotic thyroidectomy and lymph node dissection is rapidly emerging as an alternative to conventional endoscopic thyroidectomy for thyroid carcinoma. Robot techniques incorporate the advantages of endoscopic procedures while overcoming some of the problems. We present the largest multi-institution clinical study of robotic thyroidectomy for thyroid carcinomas. The robotic thyroidectomy involved gasless transaxillary approach using the da Vinci surgical robot system. ⋯ Robotic thyroidectomy using gasless transaxillary method was feasible, safe, and provided good outcomes for patients with differentiated thyroid carcinoma. Robotic technology overcame some technical limitations associated with conventional endoscopy.
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Multicenter Study
European consensus on a competency-based virtual reality training program for basic endoscopic surgical psychomotor skills.
Virtual reality (VR) simulators have been demonstrated to improve basic psychomotor skills in endoscopic surgery. The exercise configuration settings used for validation in studies published so far are default settings or are based on the personal choice of the tutors. The purpose of this study was to establish consensus on exercise configurations and on a validated training program for a virtual reality simulator, based on the experience of international experts to set criterion levels to construct a proficiency-based training program. ⋯ A European, multicenter, validated, training program was constructed according to the general consensus of a large international team with extended experience in virtual reality simulation. Therefore, a proficiency-based training program can be offered to training centers that use this simulator for training in basic psychomotor skills in endoscopic surgery.