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Erschienen in: Surgical Endoscopy 6/2006

01.06.2006 | Original Article

The impact of laparoscopic bariatric workshops on the practice patterns of surgeons

verfasst von: J. L. Lord, D. R. Cottam, R. M. Dallal, S. G. Mattar, A. R. Watson, J. M. Glasscock, R. Ramanathan, G. M. Eid, P. R. Schauer

Erschienen in: Surgical Endoscopy | Ausgabe 6/2006

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Abstract

Background

This study was designed to evaluate the impact of a 2-day laparoscopic bariatric workshop on the practice patterns of participating surgeons.

Methods

From October 1998 to June 2002, 18 laparoscopic bariatric workshops were attended by 300 surgeons. Questionnaires were mailed to all participants.

Results

Responses were received from 124 surgeons (41%), among whom were 56 bariatric surgeons (open) (45%), 30 advanced laparoscopic surgeons (24%), and 38 surgeons who performed neither bariatric nor advanced laparoscopic surgery (31%). The questionnaire responses showed that 46 surgeons (37%) currently are performing laparoscopic gastric bypass (LGB), 38 (31%) are performing open gastric bypass, and 39 (32%) are not performing bariatric surgery. Since completion of the course, 46 surgeons have performed 8,893 LGBs (mean, 193 cases/surgeon). Overall, 87 of the surgeons (70%) thought that a limited preceptorship was necessary before performance of LGB, yet only 25% underwent this additional training. According to a poll, the respondents thought that, on the average, 50 cases (range, 10–150 cases) are needed for a claim of proficiency.

Conclusion

Laparoscopic bariatric workshops are effective educational tools for surgeons wishing to adopt bariatric surgery. Open bariatric surgeons have the highest rates of adopting laparoscopic techniques and tend to participate in more adjunctive training before performing LGB. There was consensus that the learning curve is steep, and that additional training often is necessary. The authors propose a mechanism for post-residency skill acquisition for advanced laparoscopic surgery.
Literatur
1.
Zurück zum Zitat Alvarez-Cordero R (1999) IFSO statement on bariatric surgery: course and workshop requirements. Obes Surg 9: 291CrossRef Alvarez-Cordero R (1999) IFSO statement on bariatric surgery: course and workshop requirements. Obes Surg 9: 291CrossRef
2.
Zurück zum Zitat Bevan PG (1986) Craft workshops in surgery. Br J Surg 73: 1–2PubMed Bevan PG (1986) Craft workshops in surgery. Br J Surg 73: 1–2PubMed
3.
Zurück zum Zitat Chung JY, Sackier JM (1998) A method of objectively evaluating improvement in laparoscopic skills. Surg Endosc 12: 1111–1116PubMedCrossRef Chung JY, Sackier JM (1998) A method of objectively evaluating improvement in laparoscopic skills. Surg Endosc 12: 1111–1116PubMedCrossRef
4.
Zurück zum Zitat Davis D, O’Brien MA, Thomson MA, Freemantle N, Wolf F, Mazmanian P, Taylor-Vaisey A (1999) Impact of formal continuing medical education: do conferences, workshops, rounds, and other traditional continuing education activities change physician behavior or health care outcomes? JAMA 282: 867–874PubMedCrossRef Davis D, O’Brien MA, Thomson MA, Freemantle N, Wolf F, Mazmanian P, Taylor-Vaisey A (1999) Impact of formal continuing medical education: do conferences, workshops, rounds, and other traditional continuing education activities change physician behavior or health care outcomes? JAMA 282: 867–874PubMedCrossRef
5.
Zurück zum Zitat Dent TL (1991) Training, credentialing, and granting of clinical privileges for laparoscopic general surgery. Am J. Surg 161: 399–403PubMedCrossRef Dent TL (1991) Training, credentialing, and granting of clinical privileges for laparoscopic general surgery. Am J. Surg 161: 399–403PubMedCrossRef
6.
7.
Zurück zum Zitat Fitts AM, Posner MI (1967) Human performance. In: Grant EM, Whitehead AD (eds) Surgical training. Brooks-Cole. Belmont, CA pp 112–129 Fitts AM, Posner MI (1967) Human performance. In: Grant EM, Whitehead AD (eds) Surgical training. Brooks-Cole. Belmont, CA pp 112–129
9.
Zurück zum Zitat Halsted WS (1904) The training of the surgeon. Bull Johns Hopkins Hosp 15: 267 Halsted WS (1904) The training of the surgeon. Bull Johns Hopkins Hosp 15: 267
10.
Zurück zum Zitat Morino M, Festa V, Garrone C (1995) Survey on Torino courses: The impact of a two-day practical course on apprenticeship and diffusion of laparoscopic cholecystectomy in Italy. Surg Endosc 9: 46–48PubMedCrossRef Morino M, Festa V, Garrone C (1995) Survey on Torino courses: The impact of a two-day practical course on apprenticeship and diffusion of laparoscopic cholecystectomy in Italy. Surg Endosc 9: 46–48PubMedCrossRef
11.
Zurück zum Zitat Olinger A, Pistorius G, Lindemann W, Vollmar B, Hildebrandt U, Menger MD (1999) Effectiveness of a hands-on training course for laparoscopic spine surgery in a porcine model. Surg Endosc 13: 118–122PubMedCrossRef Olinger A, Pistorius G, Lindemann W, Vollmar B, Hildebrandt U, Menger MD (1999) Effectiveness of a hands-on training course for laparoscopic spine surgery in a porcine model. Surg Endosc 13: 118–122PubMedCrossRef
12.
Zurück zum Zitat Ooi LL (1996) Training in laparoscopic surgery: have we got it right yet? Ann Acad Med Singapore 25: 732–736PubMed Ooi LL (1996) Training in laparoscopic surgery: have we got it right yet? Ann Acad Med Singapore 25: 732–736PubMed
13.
Zurück zum Zitat Oria HE, Brolin RE (1999) Performance standards in bariatric surgery. Eur J Gastroenterol Hepatol 11: 77–84PubMedCrossRef Oria HE, Brolin RE (1999) Performance standards in bariatric surgery. Eur J Gastroenterol Hepatol 11: 77–84PubMedCrossRef
14.
Zurück zum Zitat Rattner DW, Apelgren KN, Eubanks WS (2001) The need for training opportunities in advanced laparoscopic surgery. Surg Endosc 15: 1066–1077PubMedCrossRef Rattner DW, Apelgren KN, Eubanks WS (2001) The need for training opportunities in advanced laparoscopic surgery. Surg Endosc 15: 1066–1077PubMedCrossRef
15.
Zurück zum Zitat Rogers D, Elstein A, Bordage G (2001). Improving continuing medical education for surgical techniques: applying the lessons learned in the first decade of minimal access surgery. Ann Surg 233: 159–166PubMedCrossRef Rogers D, Elstein A, Bordage G (2001). Improving continuing medical education for surgical techniques: applying the lessons learned in the first decade of minimal access surgery. Ann Surg 233: 159–166PubMedCrossRef
16.
Zurück zum Zitat Rosser JC, Rosser LE, Savalgi RS (1997) Skill acquisition and assessment for laparoscopic surgery. Arch Surg 132: 200–204PubMed Rosser JC, Rosser LE, Savalgi RS (1997) Skill acquisition and assessment for laparoscopic surgery. Arch Surg 132: 200–204PubMed
17.
Zurück zum Zitat Rosser JC, Rosser LE, Savalgi RS (1998) Objective evaluation of a laparoscopic surgical skill program for residents and senior surgeons. Arch Surg 1333: 657–661CrossRef Rosser JC, Rosser LE, Savalgi RS (1998) Objective evaluation of a laparoscopic surgical skill program for residents and senior surgeons. Arch Surg 1333: 657–661CrossRef
18.
Zurück zum Zitat Rosser JC, Wood M, Payne JH, Fullum TM, Lisehora GB, Rosser IE, Barcia PJ, Savalgi RS (1997) Telementoring: a practical option in surgical training. Surg Endosc 11: 852–855PubMedCrossRef Rosser JC, Wood M, Payne JH, Fullum TM, Lisehora GB, Rosser IE, Barcia PJ, Savalgi RS (1997) Telementoring: a practical option in surgical training. Surg Endosc 11: 852–855PubMedCrossRef
19.
Zurück zum Zitat Royston CM, Lansdown MR, Brough WA (1994) Teaching laparoscopic surgery: the need for guidelines. Br Med J 308: 1023–1035 Royston CM, Lansdown MR, Brough WA (1994) Teaching laparoscopic surgery: the need for guidelines. Br Med J 308: 1023–1035
20.
Zurück zum Zitat Schauer P, Ikramuddin S, Hamad G, Gourash W (2002, December 4) The learning curve for laparoscopic roux-en-y gastric bypass is 100 cases. Surg Endosc DOI: 10.1007/s00464-002-8857-z Schauer P, Ikramuddin S, Hamad G, Gourash W (2002, December 4) The learning curve for laparoscopic roux-en-y gastric bypass is 100 cases. Surg Endosc DOI: 10.1007/s00464-002-8857-z
21.
Zurück zum Zitat See WA, Cooper CS, Fisher RJ (1993). Predictors of laparoscopic complications after formal training in laparoscopic surgery. JAMA 270: 2689–2692PubMedCrossRef See WA, Cooper CS, Fisher RJ (1993). Predictors of laparoscopic complications after formal training in laparoscopic surgery. JAMA 270: 2689–2692PubMedCrossRef
22.
Zurück zum Zitat Stone MD, Doyle J (1996) The influence of surgical training on the practice of surgery: are changes necessary? Surg Clin North Am 76: 1–10PubMedCrossRef Stone MD, Doyle J (1996) The influence of surgical training on the practice of surgery: are changes necessary? Surg Clin North Am 76: 1–10PubMedCrossRef
23.
Zurück zum Zitat Tompkins RK (1990) Laparoscopic cholecystectomy: threat or opportunity? Arch Surg 125: 1245PubMed Tompkins RK (1990) Laparoscopic cholecystectomy: threat or opportunity? Arch Surg 125: 1245PubMed
24.
Zurück zum Zitat Wolfe BM, Szabo Z, Morgan ME, Chan P, Hunter JG (1993) Training for minimally invasive surgery: need for surgical skills. Surg Endosc 7: 93–95PubMedCrossRef Wolfe BM, Szabo Z, Morgan ME, Chan P, Hunter JG (1993) Training for minimally invasive surgery: need for surgical skills. Surg Endosc 7: 93–95PubMedCrossRef
25.
Zurück zum Zitat Zucker KA, Bailey RW, Graham MD, Scovil MD, Imbembo AL (1993) Training for laparoscopic surgery. World J Surg 17: 3–7PubMedCrossRef Zucker KA, Bailey RW, Graham MD, Scovil MD, Imbembo AL (1993) Training for laparoscopic surgery. World J Surg 17: 3–7PubMedCrossRef
Metadaten
Titel
The impact of laparoscopic bariatric workshops on the practice patterns of surgeons
verfasst von
J. L. Lord
D. R. Cottam
R. M. Dallal
S. G. Mattar
A. R. Watson
J. M. Glasscock
R. Ramanathan
G. M. Eid
P. R. Schauer
Publikationsdatum
01.06.2006
Erschienen in
Surgical Endoscopy / Ausgabe 6/2006
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-005-0182-x

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