Skip to main content
Top
Published in: Indian Journal of Surgery 1/2022

14-08-2021 | Laparoscopy | Others

Surgical Training: the European Minimally Invasive Skills Education Model in Urology

Authors: Emile Van Gysel, Chandra Shekhar Biyani, Ben Van Cleynenbreugel

Published in: Indian Journal of Surgery | Special Issue 1/2022

Login to get access

Abstract

The introduction of laparoscopic surgery has several advantages including shorter hospital stay, less pain, and smaller scars. This new surgical technique, however, provoked a paradigm shift in training modality. It was a difficult task to acquire these complex surgical skills in demanding and constantly changing operating room settings due to the increasing skill gap, limited time, and resources. This led to the development of proficiency-based progression (PBP) training programs outside of the operating room, with emphasis on the objective and validated performance metrics. The program can be applied to provide performance feedback to students and in tracking trainee’s development to make sure that predefined achievement benchmarks are achieved before students perform surgery on real patients. It has been repeatedly demonstrated that skills acquired in these training programs transfer to the operating room when performing laparoscopic surgery. We suggest an international implementation of these training programs in order to bring forth confident and skilled surgeons eventually leading to an improved healthcare.
Literature
1.
go back to reference Kelling G (1901) Die Tamponade der Bauchhöhle mit Luft zur Stillung lebensgefährlicher Intestinalblutungen. Münch Med Wochenschr 48:1480–1483 Kelling G (1901) Die Tamponade der Bauchhöhle mit Luft zur Stillung lebensgefährlicher Intestinalblutungen. Münch Med Wochenschr 48:1480–1483
2.
go back to reference Jacobaeus HC (1910) Ueber die Möglichkeit die Zystokopie bei Untersuchung seröser Höhlungen anzuwenden. Münch Med Wochenschr 57:2090–2092 Jacobaeus HC (1910) Ueber die Möglichkeit die Zystokopie bei Untersuchung seröser Höhlungen anzuwenden. Münch Med Wochenschr 57:2090–2092
3.
go back to reference Semm K (1977) Atlas of gynecologic laparoscopy and hysteroscopy. WB Saunders, page, Philadelphia, pp 7–14 Semm K (1977) Atlas of gynecologic laparoscopy and hysteroscopy. WB Saunders, page, Philadelphia, pp 7–14
4.
go back to reference Clayman RV, Kavoussi LR, Soper NJ, Dierks SM, Meretyk S, Darcy MD, Roemer FD, Pingleton ED, Thomson PG, Long SR (1991) Laparoscopic nephrectomy: initial case report. J Urol 146(2):278–282 PubMedCrossRef Clayman RV, Kavoussi LR, Soper NJ, Dierks SM, Meretyk S, Darcy MD, Roemer FD, Pingleton ED, Thomson PG, Long SR (1991) Laparoscopic nephrectomy: initial case report. J Urol 146(2):278–282 PubMedCrossRef
5.
go back to reference Winfield HN, Donovan JF, Godet AS, Clayman RV (1993) Laparoscopic partial nephrectomy: initial case report for benign disease. J Endourol 7(6):521–526 PubMedCrossRef Winfield HN, Donovan JF, Godet AS, Clayman RV (1993) Laparoscopic partial nephrectomy: initial case report for benign disease. J Endourol 7(6):521–526 PubMedCrossRef
6.
go back to reference Schuessler WW, Schulam PG, Clayman RV, Kavoussi LR (1997) Laparoscopic radical prostatectomy: initial short-term experience. Urology 50:854–857 PubMedCrossRef Schuessler WW, Schulam PG, Clayman RV, Kavoussi LR (1997) Laparoscopic radical prostatectomy: initial short-term experience. Urology 50:854–857 PubMedCrossRef
7.
go back to reference Schmitt F, Mariani A, Eyssartier E, Granry JC, Podevin G (2018) Learning laparoscopic skills: observation or practice? J Laparoendosc Adv Surg Tech A 28(1):89–94 PubMedCrossRef Schmitt F, Mariani A, Eyssartier E, Granry JC, Podevin G (2018) Learning laparoscopic skills: observation or practice? J Laparoendosc Adv Surg Tech A 28(1):89–94 PubMedCrossRef
8.
go back to reference Alkhaffaf B, Decadt B (2010) 15 years of litigation following laparoscopic cholecystectomy in England. Ann Surg 251(4):682–685 PubMedCrossRef Alkhaffaf B, Decadt B (2010) 15 years of litigation following laparoscopic cholecystectomy in England. Ann Surg 251(4):682–685 PubMedCrossRef
9.
go back to reference Wanzel KR, Ward M, Reznick RK (2002) Teaching the surgical craft: from selection to certification. Curr Probl Surg 39(6):573–659 PubMedCrossRef Wanzel KR, Ward M, Reznick RK (2002) Teaching the surgical craft: from selection to certification. Curr Probl Surg 39(6):573–659 PubMedCrossRef
10.
go back to reference Moore MJ, Bennett CL (1995) The learning curve for laparoscopic cholecystectomy. The southern surgeons club. Am J Surg 170:55–59 PubMedCrossRef Moore MJ, Bennett CL (1995) The learning curve for laparoscopic cholecystectomy. The southern surgeons club. Am J Surg 170:55–59 PubMedCrossRef
11.
go back to reference Olsen DO (2000) Bile duct injuries during laparoscopic cholecystectomy: a decade of experience. J Hepatobiliary Pancreat Surg 7(1):35–39 PubMedCrossRef Olsen DO (2000) Bile duct injuries during laparoscopic cholecystectomy: a decade of experience. J Hepatobiliary Pancreat Surg 7(1):35–39 PubMedCrossRef
12.
go back to reference Gallagher AG, Ritter EM, Lederman AB, McClusky DA 3rd, Smith CD (2005) Video-assisted surgery represents more than a loss of three-dimensional vision. Am J Surg 189:76–80 PubMedCrossRef Gallagher AG, Ritter EM, Lederman AB, McClusky DA 3rd, Smith CD (2005) Video-assisted surgery represents more than a loss of three-dimensional vision. Am J Surg 189:76–80 PubMedCrossRef
13.
go back to reference Canter R (2011) Impact of reduced working time on surgical training in the United Kingdom and Ireland. Surgeon 9(Suppl 1):S6-7 PubMedCrossRef Canter R (2011) Impact of reduced working time on surgical training in the United Kingdom and Ireland. Surgeon 9(Suppl 1):S6-7 PubMedCrossRef
14.
go back to reference Childers CP, Maggard-Gibbons M (2018) Understanding costs of care in the operating room. JAMA Surg 18(4):153–154 Childers CP, Maggard-Gibbons M (2018) Understanding costs of care in the operating room. JAMA Surg 18(4):153–154
15.
go back to reference Volpin A, Khan O, Haddad FS (2016) Theater Cost Is £16/Minute So What Are You Doing Just Standing There? J Arthroplasty 31(1):22–26 PubMedCrossRef Volpin A, Khan O, Haddad FS (2016) Theater Cost Is £16/Minute So What Are You Doing Just Standing There? J Arthroplasty 31(1):22–26 PubMedCrossRef
16.
go back to reference Derossis AM, Fried GM, Abrahamowicz M, Sigman HH, Barkun JS, Meakins JL (1998) Development of a model for training and evaluation of laparoscopic skills. Am J Surg 175(6):482–487 PubMedCrossRef Derossis AM, Fried GM, Abrahamowicz M, Sigman HH, Barkun JS, Meakins JL (1998) Development of a model for training and evaluation of laparoscopic skills. Am J Surg 175(6):482–487 PubMedCrossRef
17.
go back to reference Dauster B, Steinberg AP, Vassiliou MC, Bergman S, Stanbridge DD, Feldman LS, Fried GM (2005) Validity of the MISTELS simulator for laparoscopy training in urology. J Endourol 19(5):541–545 PubMedCrossRef Dauster B, Steinberg AP, Vassiliou MC, Bergman S, Stanbridge DD, Feldman LS, Fried GM (2005) Validity of the MISTELS simulator for laparoscopy training in urology. J Endourol 19(5):541–545 PubMedCrossRef
18.
go back to reference Vassiliou MC, Dunkin BJ, Marks JM, Fried GM (2010) FLS and FES: comprehensive models of training and assessment. Surg Clin North Am 90:535–558 PubMedCrossRef Vassiliou MC, Dunkin BJ, Marks JM, Fried GM (2010) FLS and FES: comprehensive models of training and assessment. Surg Clin North Am 90:535–558 PubMedCrossRef
19.
go back to reference Okrainec A, Soper NJ, Swanstrom LL, Fried GM (2011) Trends and results of the first 5 years of Fundamentals of Laparoscopic Surgery (FLS) certification testing. Surg Endos 25:1192–1198 CrossRef Okrainec A, Soper NJ, Swanstrom LL, Fried GM (2011) Trends and results of the first 5 years of Fundamentals of Laparoscopic Surgery (FLS) certification testing. Surg Endos 25:1192–1198 CrossRef
20.
go back to reference Cullinan DR, Schill MR, DeClue A, Salles A, Wise PE, Awad MM (2017) Fundamentals of laparoscopic surgery: not only for senior residents. J Surg Educ 74(6):e51–e54 PubMedPubMedCentralCrossRef Cullinan DR, Schill MR, DeClue A, Salles A, Wise PE, Awad MM (2017) Fundamentals of laparoscopic surgery: not only for senior residents. J Surg Educ 74(6):e51–e54 PubMedPubMedCentralCrossRef
21.
go back to reference Campo R, Wattiez A, Tanos V, Di Spiezio SA, Grimbizis G, Wallwiener D, Brucker S, Puga M, Molinas R, O’Donovan P, Deprest J, Van Belle Y, Lissens A, Herrmann A, Tahir M, Benedetto C, Siebert I, Rabischong B, De Wilde RL (2016) Gynaecological endoscopic surgical education and assessment. A diploma programme in gynaecological endoscopic surgery. Gynecol Surg 13:133–137 PubMedPubMedCentralCrossRef Campo R, Wattiez A, Tanos V, Di Spiezio SA, Grimbizis G, Wallwiener D, Brucker S, Puga M, Molinas R, O’Donovan P, Deprest J, Van Belle Y, Lissens A, Herrmann A, Tahir M, Benedetto C, Siebert I, Rabischong B, De Wilde RL (2016) Gynaecological endoscopic surgical education and assessment. A diploma programme in gynaecological endoscopic surgery. Gynecol Surg 13:133–137 PubMedPubMedCentralCrossRef
22.
go back to reference Lavi A, Tzemah S, Hussein A, Bishara I, Shcherbakov N, Zelichenko G, Mashiah A, Gross M, Cohen M (2017) The urology residency program in Israel: results of a residents survey and insights for the future. Rambam Maimonides Med J 8:e0039 Lavi A, Tzemah S, Hussein A, Bishara I, Shcherbakov N, Zelichenko G, Mashiah A, Gross M, Cohen M (2017) The urology residency program in Israel: results of a residents survey and insights for the future. Rambam Maimonides Med J 8:e0039
23.
go back to reference Linden-Castro E, Pelayo-Nieto M, Ramírez-Galindo I, Guzmán-Hernández F, Catalán-Quinto G, Rodríguez-Covarrubias F, Morales-Covarrubias J, Cortez-Betancourt R (2016) Urology training in Mexico: residents’ perspective. Gac Med Mex 152:339–344 PubMed Linden-Castro E, Pelayo-Nieto M, Ramírez-Galindo I, Guzmán-Hernández F, Catalán-Quinto G, Rodríguez-Covarrubias F, Morales-Covarrubias J, Cortez-Betancourt R (2016) Urology training in Mexico: residents’ perspective. Gac Med Mex 152:339–344 PubMed
24.
go back to reference Aydin A, Ahmed K, Shafi AM, Khan MS, Dasgupta P (2016) The role of simulation in urolog¬ical training – a quantitative study of practice and opinions. Surgeon 14:301–307 PubMedCrossRef Aydin A, Ahmed K, Shafi AM, Khan MS, Dasgupta P (2016) The role of simulation in urolog¬ical training – a quantitative study of practice and opinions. Surgeon 14:301–307 PubMedCrossRef
25.
go back to reference De Win G, Everaerts W, De Ridder D, Peeraer G (2015) Laparoscopy training in Belgium: results from a nationwide survey, in urology, gynecology, and general surgery residents. Adv Med Educ Pract 6:55–63 PubMedPubMedCentralCrossRef De Win G, Everaerts W, De Ridder D, Peeraer G (2015) Laparoscopy training in Belgium: results from a nationwide survey, in urology, gynecology, and general surgery residents. Adv Med Educ Pract 6:55–63 PubMedPubMedCentralCrossRef
26.
go back to reference Garde Garcia H, Ortiz Oshiro E, Ciappara Paniagua M, Poma Medrano L, Fuentes Ferrer M, Vera Gonzalez V, Moreno Sierra J (2014) Interest areas for training in endourology, laparoscopy and robotics: results of a multicentric survey among Spanish residents. Arch Esp Urol 67:673–683 PubMed Garde Garcia H, Ortiz Oshiro E, Ciappara Paniagua M, Poma Medrano L, Fuentes Ferrer M, Vera Gonzalez V, Moreno Sierra J (2014) Interest areas for training in endourology, laparoscopy and robotics: results of a multicentric survey among Spanish residents. Arch Esp Urol 67:673–683 PubMed
27.
go back to reference Furriel FT, Laguna MP, Figueiredo AJ, Nunes PT, Rassweiler JJ (2013) Training of European urology residents in laparoscopy: results of a pan-European survey. BJU Int 112:1223–1228 PubMedCrossRef Furriel FT, Laguna MP, Figueiredo AJ, Nunes PT, Rassweiler JJ (2013) Training of European urology residents in laparoscopy: results of a pan-European survey. BJU Int 112:1223–1228 PubMedCrossRef
28.
go back to reference Preston MA, Blew BD, Breau RH, Beiko D, Oake SJ, Watterson JD (2010) Survey of senior resident training in urologic laparoscopy, robotics and endourology surgery in Canada. Can Urol Assoc J 4:42–46 PubMedPubMedCentralCrossRef Preston MA, Blew BD, Breau RH, Beiko D, Oake SJ, Watterson JD (2010) Survey of senior resident training in urologic laparoscopy, robotics and endourology surgery in Canada. Can Urol Assoc J 4:42–46 PubMedPubMedCentralCrossRef
29.
go back to reference Duchene DA, Moinzadeh A, Gill IS, Clayman RV, Winfield HN (2006) Survey of residency training in laparoscopic and robotic surgery. J Urol 176:2158–2166 PubMedCrossRef Duchene DA, Moinzadeh A, Gill IS, Clayman RV, Winfield HN (2006) Survey of residency training in laparoscopic and robotic surgery. J Urol 176:2158–2166 PubMedCrossRef
31.
go back to reference Somani B, Van Cleynenbreugel B, Gözen A et al (2020) Outcomes of European Basic Laparoscopic Urological Skills (EBLUS)Examinations: results from European School of Urology (ESU) andEAU Section of Uro-Technology (ESUT) over 6 Years (2013–2018). Eur Urol Focus 6:1190–1194 PubMedCrossRef Somani B, Van Cleynenbreugel B, Gözen A et al (2020) Outcomes of European Basic Laparoscopic Urological Skills (EBLUS)Examinations: results from European School of Urology (ESU) andEAU Section of Uro-Technology (ESUT) over 6 Years (2013–2018). Eur Urol Focus 6:1190–1194 PubMedCrossRef
32.
go back to reference McGaghie WC, Issenberg SB, Cohen ER, Barsuk JH, Wayne DB (2011) Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Acad Med 86(6):706–711 PubMedPubMedCentralCrossRef McGaghie WC, Issenberg SB, Cohen ER, Barsuk JH, Wayne DB (2011) Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Acad Med 86(6):706–711 PubMedPubMedCentralCrossRef
33.
go back to reference Cook DA, Brydges R, Hamstra SJ et al (2012) Comparative effectiveness of technology-enhanced simulation vs other instructional methods: a systematic review and meta-analysis. Simul Healthc 7:308–320 PubMedCrossRef Cook DA, Brydges R, Hamstra SJ et al (2012) Comparative effectiveness of technology-enhanced simulation vs other instructional methods: a systematic review and meta-analysis. Simul Healthc 7:308–320 PubMedCrossRef
34.
go back to reference Zendejas B, Brydges R, Hamstra SJ, Cook DA (2013) State of the evidence on simulation-based training for laparoscopic surgery: a systematic review. Ann Surg 257(4):586–593 PubMedCrossRef Zendejas B, Brydges R, Hamstra SJ, Cook DA (2013) State of the evidence on simulation-based training for laparoscopic surgery: a systematic review. Ann Surg 257(4):586–593 PubMedCrossRef
35.
go back to reference Dehabadi M, Fernando B, Berlingieri P (2014) The use of simulation in the acquisition of laparoscopic suturing skills. Int J Surg 12(4):258–268 PubMedCrossRef Dehabadi M, Fernando B, Berlingieri P (2014) The use of simulation in the acquisition of laparoscopic suturing skills. Int J Surg 12(4):258–268 PubMedCrossRef
36.
go back to reference Orzech N, Palter VN, Reznick RK, Aggarwal R, Grantcharov TP (2012) A comparison of 2 ex vivo training curricula for advanced laparoscopic skills: a randomized controlled trial. Ann Surg 255(5):833–839 PubMedCrossRef Orzech N, Palter VN, Reznick RK, Aggarwal R, Grantcharov TP (2012) A comparison of 2 ex vivo training curricula for advanced laparoscopic skills: a randomized controlled trial. Ann Surg 255(5):833–839 PubMedCrossRef
37.
go back to reference Brinkmann C, Fritz M, Pankratius U, Bahde R, Neumann P, Schlueter S, Senninger N, Rijcken E (2017) Box- or virtual-reality trainer: which tool results in better transfer of laparoscopic basic skills?-a prospective randomized trial. J Surg Educ 74(4):724–735 PubMedCrossRef Brinkmann C, Fritz M, Pankratius U, Bahde R, Neumann P, Schlueter S, Senninger N, Rijcken E (2017) Box- or virtual-reality trainer: which tool results in better transfer of laparoscopic basic skills?-a prospective randomized trial. J Surg Educ 74(4):724–735 PubMedCrossRef
38.
go back to reference Alaker M, Wynn GR, Arulampalam T (2016) Virtual reality training in laparoscopic surgery: a systematic review & meta-analysis. Int J Surg 29:85–94 PubMedCrossRef Alaker M, Wynn GR, Arulampalam T (2016) Virtual reality training in laparoscopic surgery: a systematic review & meta-analysis. Int J Surg 29:85–94 PubMedCrossRef
39.
go back to reference Botden SM, Torab F, Buzink SN, Jakimowicz JJ (2008) The importance of haptic feedback in laparoscopic suturing training and the additive value of virtual reality simulation. Surg Endosc 22(5):1214–1222 PubMedCrossRef Botden SM, Torab F, Buzink SN, Jakimowicz JJ (2008) The importance of haptic feedback in laparoscopic suturing training and the additive value of virtual reality simulation. Surg Endosc 22(5):1214–1222 PubMedCrossRef
40.
go back to reference Nagendran M, Toon CD, Davidson BR, Gurusamy KS (2014) Laparoscopic surgical box model training for surgical trainees with no prior laparoscopic experience. Cochrane Database Syst Rev (1):CD010479 Nagendran M, Toon CD, Davidson BR, Gurusamy KS (2014) Laparoscopic surgical box model training for surgical trainees with no prior laparoscopic experience. Cochrane Database Syst Rev (1):CD010479
41.
go back to reference Gurusamy KS, Nagendran M, Toon CD, Davidson BR (2014) Laparoscopic surgical box model training for surgical trainees with limited prior laparoscopic experience. Cochrane Database Syst Rev (3):CD010478 Gurusamy KS, Nagendran M, Toon CD, Davidson BR (2014) Laparoscopic surgical box model training for surgical trainees with limited prior laparoscopic experience. Cochrane Database Syst Rev (3):CD010478
42.
go back to reference Verdaasdonk EG, Dankelman J, Lange JF, Stassen LP (2008) Transfer validity of laparoscopic knot-tying training on a VR simulator to a realistic environment: a randomized controlled trial. Surg Endosc 22(7):1636–1642 PubMedCrossRef Verdaasdonk EG, Dankelman J, Lange JF, Stassen LP (2008) Transfer validity of laparoscopic knot-tying training on a VR simulator to a realistic environment: a randomized controlled trial. Surg Endosc 22(7):1636–1642 PubMedCrossRef
43.
go back to reference Hyltander A, Liljegren E, Rhodin PH, Lönroth H (2002) The transfer of basic skills learned in a laparoscopic simulator to the operating room. Surg Endosc 16(9):1324–1328 PubMedCrossRef Hyltander A, Liljegren E, Rhodin PH, Lönroth H (2002) The transfer of basic skills learned in a laparoscopic simulator to the operating room. Surg Endosc 16(9):1324–1328 PubMedCrossRef
44.
go back to reference Korndorffer JR Jr, Dunne JB, Sierra R, Stefanidis D, Touchard CL, Scott DJ (2005) Simulator training for laparoscopic suturing using performance goals translates to the operating room. J Am Coll Surg 201(1):23–29 PubMedCrossRef Korndorffer JR Jr, Dunne JB, Sierra R, Stefanidis D, Touchard CL, Scott DJ (2005) Simulator training for laparoscopic suturing using performance goals translates to the operating room. J Am Coll Surg 201(1):23–29 PubMedCrossRef
45.
go back to reference Spiliotis AE, Spiliotis PM, Palios IM (2020) Transferability of simulation-based training in laparoscopic surgeries: a systematic review. Minim Invasive Surg 2020:5879485 PubMedPubMedCentral Spiliotis AE, Spiliotis PM, Palios IM (2020) Transferability of simulation-based training in laparoscopic surgeries: a systematic review. Minim Invasive Surg 2020:5879485 PubMedPubMedCentral
46.
go back to reference Gallagher AG, O'Sullivan GC (2011). Fundamentals of surgical simulation: principles and practice. Springer Science & Business Media, 2011 Gallagher AG, O'Sullivan GC (2011). Fundamentals of surgical simulation: principles and practice. Springer Science & Business Media, 2011
48.
go back to reference Somani B, Brouwers T, Veneziano D, Gözen A, Ahmed K, Liatsikos E, Sarica K et al (2021) Standardization in Surgical Education (SISE): development and implementation of an Innovative Training Program for Urologic Surgery Residents and Trainers by the European School of Urology in Collaboration with the ESUT and EULIS Sections of the EAU. Eur Urol 79:433–436 PubMedCrossRef Somani B, Brouwers T, Veneziano D, Gözen A, Ahmed K, Liatsikos E, Sarica K et al (2021) Standardization in Surgical Education (SISE): development and implementation of an Innovative Training Program for Urologic Surgery Residents and Trainers by the European School of Urology in Collaboration with the ESUT and EULIS Sections of the EAU. Eur Urol 79:433–436 PubMedCrossRef
50.
go back to reference Vanlander AE, Mazzone E, Collins JW, Mottrie AM, Rogiers XM, van der Poel HG, Van Herzeele I, Satava RM, Gallagher AG (2020) Orsi Consensus Meeting on European Robotic Training (OCERT): results from the first multispecialty consensus meeting on training in robot-assisted surgery. Eur Urol 78:713–716 PubMedCrossRef Vanlander AE, Mazzone E, Collins JW, Mottrie AM, Rogiers XM, van der Poel HG, Van Herzeele I, Satava RM, Gallagher AG (2020) Orsi Consensus Meeting on European Robotic Training (OCERT): results from the first multispecialty consensus meeting on training in robot-assisted surgery. Eur Urol 78:713–716 PubMedCrossRef
51.
go back to reference De Win G, Van Bruwaene S, Kulkarni J, Van Calster B, Aggarwal R, Allen C, Lissens A, De Ridder D, Miserez M (2016). An evidence-based laparoscopic simulation curriculum shortens the clinical learning curve and reduces surgical adverse events. Adv Med Educ Pract `7:357–70 De Win G, Van Bruwaene S, Kulkarni J, Van Calster B, Aggarwal R, Allen C, Lissens A, De Ridder D, Miserez M (2016). An evidence-based laparoscopic simulation curriculum shortens the clinical learning curve and reduces surgical adverse events. Adv Med Educ Pract `7:357–70
Metadata
Title
Surgical Training: the European Minimally Invasive Skills Education Model in Urology
Authors
Emile Van Gysel
Chandra Shekhar Biyani
Ben Van Cleynenbreugel
Publication date
14-08-2021
Publisher
Springer India
Keyword
Laparoscopy
Published in
Indian Journal of Surgery / Issue Special Issue 1/2022
Print ISSN: 0972-2068
Electronic ISSN: 0973-9793
DOI
https://doi.org/10.1007/s12262-021-03070-z

Other articles of this Special Issue 1/2022

Indian Journal of Surgery 1/2022 Go to the issue