Usefulness of a stepwise training program for laparoscopic gastrectomy. Issue 1 (12th September 2021)

• Record Type: Journal Article
• Authors: Nishi, Masaaki; Shimada, Mitsuo; Yoshikawa, Kozo; Tokunaga, Takuya; Kashihara, Hideya; Takasu, Chie; Yoshimoto, Toshiaki; Iwahashi, Shoko
• Is Part Of: Asian journal of endoscopic surgery. Volume 15:Issue 1(2022)
• Page Start: 121
• Page End: 127
• Publication Date: 2021-09-12
• Subjects: gastric cancer -- laparoscopic gastrectomy -- stepwise training; Endoscopic surgery -- Periodicals; Endoscopic surgery -- Asia -- Periodicals; 617.05705
• DOI: 10.1111/ases.12979
• Languages: English
• ISSNs: 1758-5902

Abstract

Abstract: Introduction: Laparoscopic gastrectomy (LG) is a complicated procedure with a long learning curve. This study was performed to investigate the usefulness of our stepwise training program for LG for improving the quality of the surgery. Methods: The stepwise training method comprised the following four steps: (1) basic training using a dry box and checking by mentors; (2) advanced training, including the use of animals and cadavers; (3) clinical experience, including standardization and preoperative three‐dimensional simulation; and (4) self‐assessment and feedback. In total, 153 patients who underwent curative gastrectomy for gastric cancer were included in this study. Results: The operative time gradually decreased for both laparoscopic distal gastrectomy (LDG) (2013, 395 minutes; 2017, 278 minutes; P < .001; ρ = −0.68) and laparoscopic total gastrectomy (LTG) (2013, 476 minutes; 2017, 319 minutes; P < .001; ρ = −0.56). The blood loss volume gradually decreased for both LDG (2013, 43.0 mL; 2017, 18.6 mL; P < .005; ρ = −0.30) and LTG (2013, 143.8 mL; 2017, 13.5 mL; P < .005; ρ = −0.41). Conclusions: Our stepwise training program contributes to reduce operation time and blood loss in LG.