Live surgical demonstrations for minimally invasive colorectal training

Langenbecks Arch Surg. 2020 Feb;405(1):63-69. doi: 10.1007/s00423-020-01858-3. Epub 2020 Jan 31.

Abstract

Purpose: Live surgical demonstrations are considered an effective educational tool providing a chance for trainees to observe a real-time decision-making process of expert surgeons. No data exists evaluating the impact of live surgical demonstrations on the outcomes of minimally invasive colorectal surgery. This study evaluates perioperative and short-term postoperative outcomes in patients undergoing minimally invasive colorectal surgery in the setting of live surgical demonstrations.

Methods: Patients undergoing minimally invasive colorectal surgery which was performed as live surgical demonstrations (the study group) performed between 2006 and 2018 were reviewed. These patients were case-matched with those undergoing operations in routine practice (the control group). The study and control group were compared for intraoperative and short-term postoperative outcomes.

Results: Thirty-nine live surgery cases in the study group were case-matched with its thirty-nine counterparts as the control group. Operating time was longer (200 vs 165 min; p = 0.002) and estimated intraoperative blood loss was higher in the study group (100 vs 55 ml; p = 0.008). Patients in the study group stayed longer in the hospital (6 vs 5 days; p = 0.001). While conversion (n = 4 vs n = 1, p = 0.358) and intraoperative complications (n = 6 vs n = 2, p = 0.2) were more frequent in the study group, these outcomes did not reach statistical significance. Overall complications were higher in the study group (n = 22 vs n = 9, p = 0.003). One patient underwent a reoperation due to postoperative bleeding, and one mortality occurred in the live surgery group.

Conclusions: Live surgical demonstrations in minimally invasive colorectal surgery seem to be associated with increased risk of operative morbidity.

Keywords: Colorectal; Live surgical demonstrations; Minimally invasive surgery; Surgical education; Surgical training.

MeSH terms

  • Adult
  • Aged
  • Colorectal Surgery / education*
  • Colorectal Surgery / statistics & numerical data
  • Female
  • Gastrointestinal Diseases / surgery*
  • Humans
  • Intraoperative Complications / epidemiology
  • Intraoperative Complications / etiology
  • Laparoscopy / education
  • Laparoscopy / statistics & numerical data
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / education*
  • Minimally Invasive Surgical Procedures / statistics & numerical data
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Treatment Outcome