Training curriculum in minimally invasive emergency digestive surgery : 2022 WSES position paper
de'Angelis, Nicola (University of Paris Est)
Marchegiani, Francesco (University of Paris Cité)
Schena, Carlo Alberto (University of Paris Cité)
Khan, Jim (University of Portsmouth)
Agnoletti, Vanni (Bufalini Hospital)
Ansaloni, Luca (IRCCS Policlinico San Matteo Foundation)
Barría Rodríguez, Ana Gabriela (General and Pediatric Surgery (Panamà))
Bianchi, Paolo Pietro (University of Milan)
Biffl, Walter (Scripps Memorial Hospital La Jolla)
Bravi, Francesca (Santa Maria Delle Croci Hospital)
Ceccarelli, Graziano (San Giovanni Battista Hospital)
Ceresoli, Marco (Milano-Bicocca University)
Chiara, Osvaldo (University of Milano)
Chirica, Mircea (Grenoble University)
Cobianchi, Lorenzo (University of Pavia)
Coccolini, Federico (University Hospital of Pisa (Pisa, Itàlia))
Coimbra, Raul (Riverside University Health System Medical Center)
Cotsoglou, Christian (ASST-Vimercate (Itàlia))
D'Hondt, Mathieu (Groeninge Hospital)
Damaskos, Dimitris (Royal Infirmary of Edinburgh)
De Simone, Belinda (Poissy and Saint-Germain-en-Laye Hospitals)
Di Saverio, Salomone (San Benedetto del Tronto Hospital)
Diana, Michele (Research Institute Against Digestive Cancer)
Espin-Basany, Eloy (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Fichtner-Feigl, Stefan (Medical Center University of Freiburg)
Fugazzola, Paola (IRCCS Policlinico San Matteo Foundation)
Gavriilidis, Paschalis (University Hospitals Coventry and Warwickshire NHS Trust)
Gronnier, Caroline (Bordeaux University Hospital (França))
Kashuk, Jeffry (Tel Aviv University)
Kirkpatrick, Andrew W. (Foothills Medical Centre)
Ammendola, Michele ("Mater Domini" Hospital)
Kouwenhoven, Ewout A. (Hospital Group Twente ZGT)
Laurent, Alexis (Henri Mondor University Hospital)
Leppaniemi, Ari (Helsinki University Hospital)
Lesurtel, Mickaël (University of Paris Cité)
Memeo, Riccardo (General Regional Hospital "F. Miulli")
Milone, Marco (Federico II" University of Naples)
Moore, Ernest (University of Colorado)
Pararas, Nikolaos (National and Kapodistrian University of Athens)
Peitzmann, Andrew (University of Pittsburgh School of Medicine)
Pessaux, Patrick (Institute of Viral and Liver Disease (França))
Picetti, Edoardo (Azienda Ospedaliero-Universitaria Parma)
Pikoulis, Manos (National and Kapodistrian University of Athens)
Pisano, Michele (ASST Papa Giovanni Hospital Bergamo)
Ris, Frederic (Geneva University Hospitals (Suïssa))
Robison, Tyler (Oregon Health and Science University)
Sartelli, Massimo (Macerata Hospital)
Shelat, Vishal G. (Tan Tock Seng Hospital)
Spinoglio, Giuseppe (IRCAD Faculty Member Robotic)
Sugrue, Michael (Letterkenny University Hospital)
Tan, Edward (Radboud University Medical Center)
Van Eetvelde, Ellen (UZ. Department of Digestive Surgery)
Kluger, Yoram (Rambam Healthcare Campus (Israel))
Weber, Dieter (Royal Perth Hospital (Perth, Austràlia))
Catena, Fausto (Bufalini Hospital)
Universitat Autònoma de Barcelona

Fecha:	2023
Resumen:	UDHEBRON.
Resumen:	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. 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. 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. 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. The online version contains supplementary material available at 10. 1186/s13017-023-00476-w.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Emergency surgery ; Minimally invasive surgery ; Robotic surgery ; Laparoscopy ; Training curriculum in surgery
Publicado en:	World Journal of Emergency Surgery : WJES, Vol. 18 (january 2023) , ISSN 1749-7922

DOI: 10.1186/s13017-023-00476-w
PMID: 36707879

23 p, 1.5 MB

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