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IF 2.3 4区 医学 Q2 SURGERY Pub Date : 2026-01-01
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引用次数: 0
IF 2.3 4区 医学 Q2 SURGERY Pub Date : 2026-01-01
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引用次数: 0
IF 2.3 4区 医学 Q2 SURGERY Pub Date : 2026-01-01
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引用次数: 0
IF 2.3 4区 医学 Q2 SURGERY Pub Date : 2026-01-01
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引用次数: 0
IF 2.3 4区 医学 Q2 SURGERY Pub Date : 2026-01-01
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引用次数: 0
IF 2.3 4区 医学 Q2 SURGERY Pub Date : 2026-01-01
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引用次数: 0
IF 2.3 4区 医学 Q2 SURGERY Pub Date : 2026-01-01
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引用次数: 0
IF 2.3 4区 医学 Q2 SURGERY Pub Date : 2026-01-01
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引用次数: 0
The RCSI curriculum for robotic surgery training - setting the standard for future minimally invasive surgeons. RCSI机器人手术培训课程-为未来的微创外科医生设定标准。
IF 2.3 4区 医学 Q2 SURGERY Pub Date : 2025-12-24 DOI: 10.1016/j.surge.2025.12.004
R A Keenan, D A O'Keeffe, A O'Neill, C A Fleming, R McVey, T Moran, G Fitzmaurice, E Okereke, F E Rowan, K Barry, B B McGuire
<p><strong>Introduction: </strong>The growing adoption of robotic platforms necessitates structured training to ensure safe, competent and confident use by the next generation of surgeons. Current robotic surgery training in Ireland is informal, opportunistic and inconsistent, limiting the ability of trainees to gain meaningful experience. Transitioning to robotic practice therefore is far from routine and requires exposure, experience and guidance. A curriculum for robotic surgery training to address these gaps by providing a structured, scalable, and vendor-neutral training pathway has been identified as a potential solution to address these shortcomings.</p><p><strong>Methods: </strong>The Royal College of Surgeons Ireland (RCSI) robot surgery curriculum was designed using Kern's Six-Step Framework for curriculum development, an evidence-based approach utilising six aspects for development to ensure a scalable, reproducible and practical model fit for purpose. By identifying training gaps in robotic training, essential learning outcomes were defined and appropriate educational methods designed to provide a flexible structure that can evolve over time with changes in the robotic surgery landscape. Development of the educational content was designed in consultation with the RCSI Surgical Leads Group and influenced by international best practice, namely bodies such as ERUS, BAUS and the Fundamentals of Robotic Surgery (FRS) while being uniquely adapted for the Irish training and healthcare landscape.</p><p><strong>Results: </strong>A curriculum focusing on a vendor-neutral, pan speciality approach to training was developed to develop an equitable, adaptable and strong foundational opt-in approach. Delivered over three years, initial technical skills focus is on VR simulation followed by hands-on structured training days on the foundations of assisting and robotic skills fundamentals on high fidelity hydrogel and animal models. Core human factors themes such as communication, leadership and role clarity as well as emergency preparedness are embedded in the curriculum from the outset. Success in a final knowledge and skills assessment equips the trainee with a certificate of completion. Practicalities such as supply, demand, equipment and infrastructural considerations are also discussed. Trainee and trainer feedback as well as evaluation metrics ensures the curriculum evolves and remains relevant.</p><p><strong>Conclusion: </strong>The RCSI robotic surgery curriculum provides a national strategy to the standardisation of robotic training for those who wish to pursue it, across all specialities in a vendor neutral fashion. Central to the design is to integrate essential, structured non-technical skills such as team communication, role clarity, emergency response and situational awareness to ensure a broader focus on human factors as well as technical proficiency based on theory, simulation and repetitive practice to prepare trainees for the complex
导言:机器人平台的日益普及需要结构化的培训,以确保下一代外科医生安全、胜任和自信地使用机器人平台。爱尔兰目前的机器人手术培训是非正式的、机会主义的和不一致的,限制了受训者获得有意义的经验的能力。因此,过渡到机器人实践远非常规,需要曝光,经验和指导。机器人手术培训课程通过提供结构化、可扩展和供应商中立的培训途径来解决这些差距,已被确定为解决这些缺点的潜在解决方案。方法:爱尔兰皇家外科学院(RCSI)机器人外科课程设计使用Kern的六步框架课程开发,基于证据的方法利用六个方面的发展,以确保可扩展,可复制和实用的模型适合目的。通过识别机器人培训中的培训差距,定义了基本的学习成果,并设计了适当的教育方法,以提供一个灵活的结构,可以随着机器人手术领域的变化而随时间发展。教育内容的开发是在与RCSI外科领导小组协商后设计的,并受到国际最佳实践的影响,即ERUS、BAUS和机器人手术基础(FRS)等机构的影响,同时对爱尔兰的培训和医疗保健领域进行了独特的调整。结果:制定了一个侧重于供应商中立、泛专业培训方法的课程,以发展一种公平、适应性强和强有力的基础选择加入方法。交付三年多,最初的技术技能重点是VR模拟,然后是在高保真水凝胶和动物模型的辅助和机器人技能基础上的动手结构化培训日。核心人为因素主题,如沟通、领导能力和角色清晰度以及应急准备,从一开始就被纳入课程。通过最后的知识和技能评估,学员将获得结业证书。还讨论了供应、需求、设备和基础设施等方面的实际情况。学员和培训师的反馈以及评估指标确保课程的发展并保持相关性。结论:RCSI机器人外科课程为那些希望从事机器人培训的人提供了一个标准化的国家战略,涵盖所有专业,以供应商中立的方式。设计的核心是整合必要的、结构化的非技术技能,如团队沟通、角色清晰、应急响应和态势感知,以确保更广泛地关注人为因素,以及基于理论、模拟和重复实践的技术熟练程度,为学员准备复杂的基于团队的机器人手术现实。
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引用次数: 0
Abdominal aortic aneurysm (AAA) screening and the Irish context. 腹主动脉瘤(AAA)筛查和爱尔兰背景。
IF 2.3 4区 医学 Q2 SURGERY Pub Date : 2025-12-24 DOI: 10.1016/j.surge.2025.12.003
Morgan Thomas McLoughlin, Nawar Masarani, Mohammed Elkassaby, Gergely Gosi

Introduction: The 2024 European Society for Vascular Surgery (ESVS) guidelines mark a paradigm shift in recommendations for abdominal aortic aneurysm (AAA) screening, moving from population-specific to risk-based criteria. Whilst the aim of this approach is to foster local adaptation, countries, like Ireland, have yet to develop corresponding national guidance.

Aim: This commentary explores the implications of this shift, contrasts the 2019 and 2024 ESVS recommendations, and highlights the critical need for updates in Irish-specific screening framework grounded in local epidemiology and international best practice.

Methods: The paper incorporates evidence from ESVS guidelines, systematic reviews, cost-benefit analyses, and international comparisons to create a narrative discussion on AAA screening in the Irish context and recommend proposals for change.

Results: The results of this review support ultrasound screening for men aged 65 years or older with a smoking history or atherosclerotic disease risk factors. Screening should also be recommended for individuals with peripheral aneurysms or a history of organ transplantation. Individuals with a strong family history (i.e. first degree relative) should continue ultrasound screening at the age of 50.

Conclusion: The shift in guidelines toward localised, high-risk screening frameworks requires countries to act. Ireland currently lacks the infrastructure and policy to support this change, leaving vulnerable populations at risk. Until a formal national screening strategy is implemented, informal and inconsistent screening will continue to depend on individual physician initiative. In this interim period, it is essential to equip clinicians with updated contemporary literature to accurately identify high-risk individuals who would benefit from screening.

2024年欧洲血管外科学会(ESVS)指南标志着腹主动脉瘤(AAA)筛查建议的范式转变,从人群特异性标准转向基于风险的标准。虽然这种方法的目的是促进当地的适应,但像爱尔兰这样的国家尚未制定相应的国家指导方针。目的:本文探讨了这一转变的影响,对比了2019年和2024年ESVS的建议,并强调了基于当地流行病学和国际最佳实践的爱尔兰特定筛查框架更新的迫切需要。方法:本文结合了ESVS指南、系统综述、成本效益分析和国际比较的证据,对爱尔兰背景下的AAA筛查进行了叙述性讨论,并提出了改革建议。结果:本综述的结果支持对有吸烟史或动脉粥样硬化疾病危险因素的65岁及以上男性进行超声筛查。外周动脉瘤患者或有器官移植史的患者也应进行筛查。有强烈家族史的人(即第一级亲属)应在50岁时继续进行超声筛查。结论:指南向本地化高风险筛查框架的转变要求各国采取行动。爱尔兰目前缺乏支持这一变化的基础设施和政策,使弱势群体处于危险之中。在正式的国家筛查战略实施之前,非正式和不一致的筛查将继续取决于医生个人的主动性。在这个过渡时期,临床医生必须掌握最新的当代文献,以准确识别高危人群,谁将受益于筛查。
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Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
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