Skip to main content
Top
Published in: World Journal of Surgery 11/2019

01-11-2019 | Liver Surgery | Original Scientific Report

Laparoscopic Liver Surgery Training Course on Thiel-Embalmed Human Cadavers: Program Evaluation, Trainer’s Long-Term Feedback and Steps Forward

Authors: Nikdokht Rashidian, Wouter Willaert, Mariano Cesare Giglio, Vincenzo Scuderi, Francesca Tozzi, Aude Vanlander, Katharina D’Herde, Adnan Alseidi, Roberto I. Troisi

Published in: World Journal of Surgery | Issue 11/2019

Login to get access

Abstract

Objectives

The purpose of this study was to evaluate the feedback of participants upon laparoscopic liver surgery (LLS) course on Thiel-embalmed human bodies.

Methods

From 2010 to 2017, ten LLS masterclasses have been organized by the Department of Hepatobiliary Surgery at Ghent University Hospital. A 23-question anonymous survey was electronically sent to 119 participants between November 2017 and January 2018, exploring their characteristics and asking for evaluation of the course. The obstacles for implementing LLS in their centers have been assessed.

Results

Sixty-four surgeons (53.8%) responded to the survey; 42 (65.6%) were employed at a university hospital; and 39 (60.9%) were in the first decade of their practice as a consultant surgeon. Forty-three (67.2%) surgeons reported an increased percentage of LLS cases afterward. Training on Thiel cadavers was considered superior (49.2%) to other training options including proctoring in the operating room (34.9%), virtual reality (6.3%), video training (4.8%) and practicing on pigs (4.8%). Obstacles identified contained inadequate training, patient’s referral pattern, financial issues, lack of dedicated surgical team and time constrains.

Conclusions

This survey revealed that a structured short-time program incorporating interactive discussion, live operations and hands-on training on human bodies under proctorship may enhance efficient training in laparoscopic liver surgery. In a step forward for upcoming courses, the importance of team building has to be addressed.
Literature
1.
go back to reference Ciria R, Cherqui D, Geller DA et al (2016) Comparative short-term benefits of laparoscopic liver resection: 9000 cases and climbing. Ann Surg 263(4):761–777CrossRef Ciria R, Cherqui D, Geller DA et al (2016) Comparative short-term benefits of laparoscopic liver resection: 9000 cases and climbing. Ann Surg 263(4):761–777CrossRef
2.
go back to reference Tomassini F, Scuderi V, Colman R et al (2016) The single surgeon learning curve of laparoscopic liver resection: a continuous evolving process through stepwise difficulties. Medicine (Baltimore) 95(43):5138CrossRef Tomassini F, Scuderi V, Colman R et al (2016) The single surgeon learning curve of laparoscopic liver resection: a continuous evolving process through stepwise difficulties. Medicine (Baltimore) 95(43):5138CrossRef
3.
go back to reference Berardi G, Van Cleven S, Fretland AA et al (2017) Evolution of laparoscopic liver surgery from innovation to implementation to mastery: perioperative and oncologic outcomes of 2,238 patients from 4 European specialized centers. J Am Coll Surg 225:639–649CrossRef Berardi G, Van Cleven S, Fretland AA et al (2017) Evolution of laparoscopic liver surgery from innovation to implementation to mastery: perioperative and oncologic outcomes of 2,238 patients from 4 European specialized centers. J Am Coll Surg 225:639–649CrossRef
4.
go back to reference Wakabayashi G, Cherqui D, Geller DA et al (2015) Recommendations for laparoscopic liver resection: a report from the second international consensus conference held in Morioka. Ann Surg 261:619–629PubMed Wakabayashi G, Cherqui D, Geller DA et al (2015) Recommendations for laparoscopic liver resection: a report from the second international consensus conference held in Morioka. Ann Surg 261:619–629PubMed
5.
go back to reference Abu Hilal M, Aldrighetti L, Dagher I et al (2018) The Southampton consensus guidelines for laparoscopic liver surgery: from indication to implementation. Ann Surg 268(1):11–18CrossRef Abu Hilal M, Aldrighetti L, Dagher I et al (2018) The Southampton consensus guidelines for laparoscopic liver surgery: from indication to implementation. Ann Surg 268(1):11–18CrossRef
6.
go back to reference Jrearz R, Govindarajan A, Jayaraman S (2017) A survey of current practices and barriers to expanding laparoscopic HPB surgery in Canada. HPB (Oxford) 19(1):42–46CrossRef Jrearz R, Govindarajan A, Jayaraman S (2017) A survey of current practices and barriers to expanding laparoscopic HPB surgery in Canada. HPB (Oxford) 19(1):42–46CrossRef
7.
go back to reference Vigano L, Laurent A, Tayar C et al (2009) The learning curve in laparoscopic liver resection: improved feasibility and reproducibility. Ann Surg 250(5):772–782CrossRef Vigano L, Laurent A, Tayar C et al (2009) The learning curve in laparoscopic liver resection: improved feasibility and reproducibility. Ann Surg 250(5):772–782CrossRef
8.
go back to reference Hasegawa Y, Nitta H, Takahara T et al (2017) Safely extending the indications of laparoscopic liver resection: when should we start laparoscopic major hepatectomy? Surg Endosc 31:309–316CrossRef Hasegawa Y, Nitta H, Takahara T et al (2017) Safely extending the indications of laparoscopic liver resection: when should we start laparoscopic major hepatectomy? Surg Endosc 31:309–316CrossRef
9.
go back to reference Halls MC, Alseidi A, Berardi G et al (2019) A comparison of the learning curves of laparoscopic liver surgeons in differing stages of the IDEAL paradigm of surgical innovation: standing on the shoulders of pioneers. Ann Surg 269(2):221–228CrossRef Halls MC, Alseidi A, Berardi G et al (2019) A comparison of the learning curves of laparoscopic liver surgeons in differing stages of the IDEAL paradigm of surgical innovation: standing on the shoulders of pioneers. Ann Surg 269(2):221–228CrossRef
10.
go back to reference Strickland A, Fairhurst K, Lauder C et al (2011) Development of an ex vivo simulated training model for laparoscopic liver resection. Surg Endosc 25(5):1677–1682CrossRef Strickland A, Fairhurst K, Lauder C et al (2011) Development of an ex vivo simulated training model for laparoscopic liver resection. Surg Endosc 25(5):1677–1682CrossRef
11.
go back to reference Xiao J, Cui Z, Fu M et al (2016) An ex vivo liver training model continuously perfused to simulate bleeding for suture skills involved in laparoscopic liver resection: development and validity. Surg Endosc 30(10):4553–4561CrossRef Xiao J, Cui Z, Fu M et al (2016) An ex vivo liver training model continuously perfused to simulate bleeding for suture skills involved in laparoscopic liver resection: development and validity. Surg Endosc 30(10):4553–4561CrossRef
12.
go back to reference Komorowski AL, Mituś JW, Sanchez Hurtado MA et al (2015) Porcine model in the laparoscopic liver surgery training. Pol Przegl Chir 87(8):425–428CrossRef Komorowski AL, Mituś JW, Sanchez Hurtado MA et al (2015) Porcine model in the laparoscopic liver surgery training. Pol Przegl Chir 87(8):425–428CrossRef
13.
go back to reference Teh SH, Hunter JG, Sheppard BC (2007) A suitable animal model for laparoscopic hepatic resection training. Surg Endosc 21:1738–1744CrossRef Teh SH, Hunter JG, Sheppard BC (2007) A suitable animal model for laparoscopic hepatic resection training. Surg Endosc 21:1738–1744CrossRef
14.
go back to reference Udomsawaengsup S, Pattana-arun J, Tansatit T et al (2005) Minimally invasive surgery training in soft cadaver (MIST-SC). J Med Assoc Thail 88:189–194 Udomsawaengsup S, Pattana-arun J, Tansatit T et al (2005) Minimally invasive surgery training in soft cadaver (MIST-SC). J Med Assoc Thail 88:189–194
15.
go back to reference White SA, Satchidanand RY, French JJ et al (2014) A cadaver lab training facility to facilitate laparoscopic liver resection. Surg Laparosc Endosc Percutaneous Tech 24:357–360CrossRef White SA, Satchidanand RY, French JJ et al (2014) A cadaver lab training facility to facilitate laparoscopic liver resection. Surg Laparosc Endosc Percutaneous Tech 24:357–360CrossRef
16.
go back to reference Nobuoka D, Yagi T, Kondo Y et al (2017) The utility of cadaver-based surgical training in hepatobiliary and pancreatic surgery. J Hepato Biliary Pancreat Sci 24:A338CrossRef Nobuoka D, Yagi T, Kondo Y et al (2017) The utility of cadaver-based surgical training in hepatobiliary and pancreatic surgery. J Hepato Biliary Pancreat Sci 24:A338CrossRef
17.
go back to reference Bates R (2004) A critical analysis of evaluation practice: the Kirkpatrick model and the principle of beneficence. Eval Program Plan 27:341–347CrossRef Bates R (2004) A critical analysis of evaluation practice: the Kirkpatrick model and the principle of beneficence. Eval Program Plan 27:341–347CrossRef
18.
go back to reference Cai XJ, Li ZY, Zhang YL et al (2014) Laparoscopic liver resection and the learning curve: a 14-year, single-center experience. Surg Endosc 28:1334–1341CrossRef Cai XJ, Li ZY, Zhang YL et al (2014) Laparoscopic liver resection and the learning curve: a 14-year, single-center experience. Surg Endosc 28:1334–1341CrossRef
19.
go back to reference Nomi T, Fuks D, Kawaguchi Y et al (2015) Learning curve for laparoscopic major hepatectomy. Br J Surg 102:796–804CrossRef Nomi T, Fuks D, Kawaguchi Y et al (2015) Learning curve for laparoscopic major hepatectomy. Br J Surg 102:796–804CrossRef
20.
go back to reference Chang YJ, Mittal VK (2009) Hepato-pancreato-biliary training in general surgery residency: is it enough for the real world? Am J Surg 197(3):291–295CrossRef Chang YJ, Mittal VK (2009) Hepato-pancreato-biliary training in general surgery residency: is it enough for the real world? Am J Surg 197(3):291–295CrossRef
21.
go back to reference Subhas G, Mittal VK (2011) Training minimal invasive approaches in hepatopancreatobilliary fellowship: the current status. HPB (Oxford) 13(3):149–152CrossRef Subhas G, Mittal VK (2011) Training minimal invasive approaches in hepatopancreatobilliary fellowship: the current status. HPB (Oxford) 13(3):149–152CrossRef
22.
go back to reference Beyer-Berjot L, Palter V, Grantcharov T et al (2014) Advanced training in laparoscopic abdominal surgery (Atlas): a systematic review. Surgery 156(3):676–688CrossRef Beyer-Berjot L, Palter V, Grantcharov T et al (2014) Advanced training in laparoscopic abdominal surgery (Atlas): a systematic review. Surgery 156(3):676–688CrossRef
23.
go back to reference Eisma R, Wilkinson T (2014) From “Silent Teachers” to models. PLoS Biol 12(10):e1001971CrossRef Eisma R, Wilkinson T (2014) From “Silent Teachers” to models. PLoS Biol 12(10):e1001971CrossRef
24.
go back to reference Giger U, Fresard I, Hafliger A et al (2008) Laparoscopic training on Thiel human cadavers: a model to teach advanced laparoscopic procedures. Surg Endosc 22:901–906CrossRef Giger U, Fresard I, Hafliger A et al (2008) Laparoscopic training on Thiel human cadavers: a model to teach advanced laparoscopic procedures. Surg Endosc 22:901–906CrossRef
25.
go back to reference Supe A, Dalvi A, Prabhu R et al (2005) Cadaver as a model for laparoscopic training. Indian J Gastroenterol 24:111–113PubMed Supe A, Dalvi A, Prabhu R et al (2005) Cadaver as a model for laparoscopic training. Indian J Gastroenterol 24:111–113PubMed
26.
go back to reference Willaert W, Tozzi F, Van Herzeele I et al (2018) Systematic review of surgical training on reperfused human cadavers. Acta Chir Belg 13:1–11 Willaert W, Tozzi F, Van Herzeele I et al (2018) Systematic review of surgical training on reperfused human cadavers. Acta Chir Belg 13:1–11
27.
go back to reference Balta JY, Cronin M, Cryan JF et al (2015) Human preservation techniques in anatomy: a 21st century medical education perspective. Clin Anat 28(6):725–734CrossRef Balta JY, Cronin M, Cryan JF et al (2015) Human preservation techniques in anatomy: a 21st century medical education perspective. Clin Anat 28(6):725–734CrossRef
28.
go back to reference Chevallier C, Willaert W, Kawa E et al (2014) Postmortem circulation: a new model for testing endovascular devices and training clinicians in their use. Clin Anat 27(4):556–562CrossRef Chevallier C, Willaert W, Kawa E et al (2014) Postmortem circulation: a new model for testing endovascular devices and training clinicians in their use. Clin Anat 27(4):556–562CrossRef
29.
go back to reference Wolff KD, Fichter A, Braun C, Bauer F et al (2014) Flap raising on pulsatile perfused cadaveric tissue: a novel method for surgical teaching and exercise. J Craniomaxillofac Surg 42(7):1423–1427CrossRef Wolff KD, Fichter A, Braun C, Bauer F et al (2014) Flap raising on pulsatile perfused cadaveric tissue: a novel method for surgical teaching and exercise. J Craniomaxillofac Surg 42(7):1423–1427CrossRef
30.
go back to reference Aboud ET, Krisht AF, O’Keeffe T et al (2011) Novel simulation for training trauma surgeons. J Trauma 71:1484–1490PubMed Aboud ET, Krisht AF, O’Keeffe T et al (2011) Novel simulation for training trauma surgeons. J Trauma 71:1484–1490PubMed
31.
go back to reference Monbailliu T, Troisi RI, Willaert W (2018) Postgraduates’ experience with laparoscopic training on reperfused Thiel embalmed human livers. Oral communication, 19th Belgian Surgical Week, Ostend-Belgium, 3–5 May 2018 Monbailliu T, Troisi RI, Willaert W (2018) Postgraduates’ experience with laparoscopic training on reperfused Thiel embalmed human livers. Oral communication, 19th Belgian Surgical Week, Ostend-Belgium, 3–5 May 2018
Metadata
Title
Laparoscopic Liver Surgery Training Course on Thiel-Embalmed Human Cadavers: Program Evaluation, Trainer’s Long-Term Feedback and Steps Forward
Authors
Nikdokht Rashidian
Wouter Willaert
Mariano Cesare Giglio
Vincenzo Scuderi
Francesca Tozzi
Aude Vanlander
Katharina D’Herde
Adnan Alseidi
Roberto I. Troisi
Publication date
01-11-2019
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 11/2019
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-019-05103-x

Other articles of this Issue 11/2019

World Journal of Surgery 11/2019 Go to the issue

Original Scientific Report

Surgical Notes: To Play or Not to Play