Efficacy Of Animal VATS Lobectomy Training Program For Novice Thoracic Surgical Residents
YOOHWA HWANG, Samina Park, Hyun Joo Lee, In-Kyu Park, Chang Hyun Kang, Young Tae Kim.
SEOUL NATIONAL UNIVERSITY HOSPITAL, SEOUL, Korea, Republic of.
OBJECTIVE: Video Assisted Thoracic Surgery (VATS) requires surgeons to have a different level of skills and capabilities from that of open surgery. To improve the quality of residents' education, we set up an "animal-VATS-lobectomy-training-program" for novice thoracic surgical residents. We aimed to determine if the training program could improve performance outcomes.
METHODS: Between 2013 and 2015, 12 canine VATS lobectomy training courses were conducted. On each course, 4 thoracic surgical residents performed VATS lobectomies including RUL, RML, RLL and accessory lobe with a standard 3 port surgical techniques. The training program was approved by IACUC of the hospital animal laboratory. Six cardiothoracic surgery board certified proctors supervised the entire procedure. The performances of trainees were evaluated by proctors as well as themselves.
RESULTS: A total of 22 thoracic surgical residents performed 48 VATS lobectomies and each resident finished 1-4 times of the course. The mean total score by proctor improved significantly between the first and 4th repetition (64.9±8.5 to 81.8± 10.1, p<0.01).The self-evaluation score showed similar results (4.7± 2.1 to 7.5±1.7, p=0.01). (Figure) The time to finish lobectomy decreased significantly from the initial 73.4 ± 26.8 minutes to 49.1 ± 11.9 minutes, p<0.01) minutes at the 4th repetition. Subjectively, the skill of instrumentation as well as procedural understanding improved with repetitive sessions. Subjectively, the skill of instrumentation as well as procedural understanding improved with repetitive sessions.
CONCLUSIONS: We observed the performance as well as surgical understanding of the residents improved by repetitive courses of animal VATS lobectomy program. Given the obseved positive impact on the surgical education, the animal VATS lobectomy program should be included in a resident education program in cardiothoracic surgery.
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