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Training curriculum in minimally invasive emergency digestive surgery: 2022 WSES position paper.

ABSTRACT:

Background

Minimally invasive surgery (MIS), including laparoscopic and robotic approaches, is widely adopted in elective digestive surgery, but selectively used for surgical emergencies. The present position paper summarizes the available evidence concerning the learning curve to achieve proficiency in emergency MIS and provides five expert opinion statements, which may form the basis for developing standardized curricula and training programs in emergency MIS.

Methods

This position paper was conducted according to the World Society of Emergency Surgery methodology. A steering committee and an international expert panel were involved in the critical appraisal of the literature and the development of the consensus statements.

Results

Thirteen studies regarding the learning curve in emergency MIS were selected. All but one study considered laparoscopic appendectomy. Only one study reported on emergency robotic surgery. In most of the studies, proficiency was achieved after an average of 30 procedures (range: 20-107) depending on the initial surgeon's experience. High heterogeneity was noted in the way the learning curve was assessed. The experts claim that further studies investigating learning curve processes in emergency MIS are needed. The emergency surgeon curriculum should include a progressive and adequate training based on simulation, supervised clinical practice (proctoring), and surgical fellowships. The results should be evaluated by adopting a credentialing system to ensure quality standards. Surgical proficiency should be maintained with a minimum caseload and constantly evaluated. Moreover, the training process should involve the entire surgical team to facilitate the surgeon's proficiency.

Conclusions

Limited evidence exists concerning the learning process in laparoscopic and robotic emergency surgery. The proposed statements should be seen as a preliminary guide for the surgical community while stressing the need for further research.

SUBMITTER: de'Angelis N

PROVIDER: S-EPMC9883976 | biostudies-literature | 2023 Jan

REPOSITORIES: biostudies-literature

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Training curriculum in minimally invasive emergency digestive surgery: 2022 WSES position paper.

de'Angelis Nicola N Marchegiani Francesco F Schena Carlo Alberto CA Khan Jim J Agnoletti Vanni V Ansaloni Luca L Barría Rodríguez Ana Gabriela AG Bianchi Paolo Pietro PP Biffl Walter W Bravi Francesca F Ceccarelli Graziano G Ceresoli Marco M Chiara Osvaldo O Chirica Mircea M Cobianchi Lorenzo L Coccolini Federico F Coimbra Raul R Cotsoglou Christian C D'Hondt Mathieu M Damaskos Dimitris D De Simone Belinda B Di Saverio Salomone S Diana Michele M Espin-Basany Eloy E Fichtner-Feigl Stefan S Fugazzola Paola P Gavriilidis Paschalis P Gronnier Caroline C Kashuk Jeffry J Kirkpatrick Andrew W AW Ammendola Michele M Kouwenhoven Ewout A EA Laurent Alexis A Leppaniemi Ari A Lesurtel Mickaël M Memeo Riccardo R Milone Marco M Moore Ernest E Pararas Nikolaos N Peitzmann Andrew A Pessaux Patrick P Picetti Edoardo E Pikoulis Manos M Pisano Michele M Ris Frederic F Robison Tyler T Sartelli Massimo M Shelat Vishal G VG Spinoglio Giuseppe G Sugrue Michael M Tan Edward E Van Eetvelde Ellen E Kluger Yoram Y Weber Dieter D Catena Fausto F

World journal of emergency surgery : WJES 20230127 1

<h4>Background</h4>Minimally invasive surgery (MIS), including laparoscopic and robotic approaches, is widely adopted in elective digestive surgery, but selectively used for surgical emergencies. The present position paper summarizes the available evidence concerning the learning curve to achieve proficiency in emergency MIS and provides five expert opinion statements, which may form the basis for developing standardized curricula and training programs in emergency MIS.<h4>Methods</h4>This posit ...[more]

PMID: 36707879

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Dataset Information

Training curriculum in minimally invasive emergency digestive surgery: 2022 WSES position paper.

Background

Methods

Results

Conclusions

Publications

Training curriculum in minimally invasive emergency digestive surgery: 2022 WSES position paper.

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