Surgery open science最新文献_第7页

The impact of online teaching curricula on undergraduate basic surgical skills acquisition 网络教学课程对本科外科基本技能习得的影响

IF 1.4 Q3 SURGERY

Surgery open science

Pub Date : 2025-06-06 DOI: 10.1016/j.sopen.2025.06.002

Devansh Tandon , Ayush Gupta , Rhianna Patel , Anushka Shukla , Saran Singh Gill , Rhea Elise Patel , Keshav Krishnan , Bishoy Yassa , Shivansh Tandon , Amar Rai , Matt Boal , Nader Francis

Introduction

Despite the growing use of online teaching in medical education, undergraduate surgical skills training remains predominantly face-to-face, with limited structured curricula and resources. Consequently, many students lack confidence performing basic procedures independently. While online programmes offer a potential alternative, comparative evidence is limited. This service evaluation assessed the effectiveness of online surgical skills teaching on student skill acquisition and confidence.

Methods

Medical students who participated in five UK national surgical skills programmes between 2022 and 2024 were selected, having received either online or face-to-face instruction. Skill acquisition was measured using the Objective Structured Assessment of Technical Skills (OSATS) tool and confidence was measured pre- and post-training via a Likert scale. Non-parametric data were analysed using the Mann-Whitney U test, with significance set at p < 0.05.

Results

Of 133 participants, 82 received online and 51 face-to-face training. Fifty-six percent were in their first or second year of study. No significant differences were found in continuous (p = 0.0652) or mattress suturing (p = 0.143), while interrupted suturing scores were significantly higher in the online group (p = 0.0143). Both modalities significantly improved confidence (p < 0.0001), with no significant difference between groups (p > 0.05).

Conclusion

This study demonstrates that online surgical skills teaching is as effective as face-to-face methods, with both positively impacting skill acquisition and confidence. A hybrid approach, integrating online and face-to-face teaching, could optimise learning by combining the scalability of online instruction with essential practical experience, enhancing medical students' confidence and technical proficiency in surgical skills.

尽管在医学教育中越来越多地使用在线教学，但本科外科技能培训仍然主要是面对面的，结构化的课程和资源有限。因此，许多学生缺乏独立执行基本程序的信心。尽管在线课程提供了一种潜在的替代方案，但比较证据有限。本服务评估评估了在线外科技能教学对学生技能习得和信心的效果。方法选择2022年至2024年期间参加5个英国国家外科技能项目的医学生，接受在线或面对面教学。使用客观结构化技术技能评估（OSATS）工具测量技能习得，通过李克特量表测量培训前和培训后的信心。非参数数据分析采用Mann-Whitney U检验，显著性设置为p <；0.05.结果133名参与者中，82人接受了在线培训，51人接受了面对面培训。56%的学生是一年级或二年级学生。连续缝合组（p = 0.0652）和床垫缝合组（p = 0.143）的评分差异无统计学意义，而间断缝合组（p = 0.0143）的评分明显高于在线组（p = 0.0143）。两种方式都显著提高了信心(p <；0.0001)，组间无显著差异(p >；0.05)。结论本研究表明，在线外科技能教学与面对面教学一样有效，对技能习得和信心都有积极的影响。将在线和面对面教学相结合的混合方法，可以通过将在线教学的可扩展性与必要的实践经验相结合，优化学习，增强医学生对外科技能的信心和技术熟练程度。

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引用次数: 0

Editorial Board Page 编委会页面

IF 1.4 Q3 SURGERY

Surgery open science

Pub Date : 2025-06-01 DOI: 10.1016/S2589-8450(25)00052-1

引用次数: 0

Role of cholecystectomy in hyperkinetic biliary dyskinesia: A systematic review and meta-analysis 胆囊切除术在高运动性胆道运动障碍中的作用：一项系统综述和荟萃分析

IF 1.4 Q3 SURGERY

Surgery open science

Pub Date : 2025-06-01 DOI: 10.1016/j.sopen.2025.06.001

Duyen Quach MD , Kayla Nguyen MD , Gabriella Tavera BS , Rachel Wright MD , Zuhair Ali MD , Mike Liang MD

Background

Biliary dyskinesia is disorder characterized by reduced gallbladder ejection fraction, which have shown a good response to cholecystectomy. In contrast, hyperkinetic biliary dyskinesia (HBD), as defined by ejection fraction ≥80 %, is an emerging phenomenon, and the role of cholecystectomy is not yet clearly defined. This review investigates the effectiveness of cholecystectomy in alleviating symptoms of HBD.

Material and methods

A comprehensive literature search was conducted to retrieve studies based on predefined inclusion criteria. Data were extracted by two-independent reviewers. A random-effects model was used for meta-analysis. Risk ratios (RR) were calculated to estimate the impact of cholecystectomy on symptom improvement. Heterogeneity was calculated using the I² statistic and Q-test, with subgroup analyses performed based on study design.

Results

Fourteen studies involving 416 patients with HBD were included. Overall, the pooled RR for symptom relief post-cholecystectomy was 3.72 (95 % CI: 2.57–5.38). A subgroup analysis of retrospective reviews showed an RR of 3.9 (95 % CI: 2.57–5.92). Moderate heterogeneity (I² = 30.01 %) was observed.

Conclusion

Based on existing evidence, cholecystectomy appeared to be a promising and effective treatment for HBD in select patients.

胆道运动障碍是一种以胆囊射血分数降低为特征的疾病，在胆囊切除术后表现出良好的反应。相比之下，以射血分数≥80%为定义的胆道运动障碍（hyperkinetic biliary dydyesia， HBD）是一种新兴现象，胆囊切除术的作用尚未明确定义。本文综述了胆囊切除术在缓解HBD症状方面的有效性。材料和方法根据预先确定的纳入标准进行全面的文献检索。数据由两位独立审稿人提取。meta分析采用随机效应模型。计算风险比（RR）来评估胆囊切除术对症状改善的影响。采用I2统计量和q检验计算异质性，并根据研究设计进行亚组分析。结果纳入14项研究，涉及416例HBD患者。总体而言，胆囊切除术后症状缓解的总RR为3.72 （95% CI: 2.57-5.38）。回顾性分析的亚组分析显示RR为3.9 （95% CI: 2.57-5.92）。观察到中度异质性（I2 = 30.01%）。结论根据现有证据，胆囊切除术似乎是一种有希望且有效的治疗HBD的方法。

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引用次数: 0

Association of body mass index and outcomes in surgical and transcatheter aortic valve replacement 体质量指数与手术和经导管主动脉瓣置换术预后的关系

IF 1.4 Q3 SURGERY

Surgery open science

Pub Date : 2025-06-01 DOI: 10.1016/j.sopen.2025.05.008

Bennet S. Cho MD , Troy N. Coaston BS , Amulya Vadlakonda BS , Sara Sakowitz MPH, MS , Syed Shaheer Ali , Esteban Aguayo MD , Peyman Benharash MD

Background

The association between body mass index (BMI) and outcomes in surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR) is not well understood. This study assessed the nuanced relationship between BMI and clinical outcomes in a nationally representative cohort undergoing aortic valve replacement.

Methods

Adult (≥18 years) admissions for elective SAVR or TAVR from the 2016–2021 National Inpatient Sample were analyzed. BMI was categorized as underweight (<20), ideal weight (20–30), obesity class I (30–34.9), class II (35–39.9), and class III (≥40). The primary outcome was in-hospital mortality. Secondary outcomes included major adverse events (MAE), a composite of mortality and complications (e.g., stroke, thromboembolic, cardiac, respiratory, infection, renal).

Results

Among 103,000 patients, 61.2 % underwent TAVR. TAVR patients were older (76 vs. 64 years; p < 0.001) and more frequently underweight (3.1 % vs. 1.5 %; p < 0.001) compared to SAVR patients. In TAVR, BMI < 20 was associated with higher mortality (AOR 2.99, 95 % CI 1.16–7.74) and MAE (AOR 1.74, 95 % CI 1.30–2.34) compared to ideal BMI. Obesity did not increase the overall incidence of MAE in patients undergoing TAVR. In SAVR, mortality was not associated with BMI, but underweight (AOR 2.05, 95 % CI 1.33–3.15) and class III obesity (AOR 1.34, 95 % CI 1.09–1.65) were linked to higher MAE risk.

Conclusions

Extremes of BMI results in poorer outcomes in SAVR and TAVR. Underweight patients had increased risks across both approaches, while severe obesity elevated MAE risk in SAVR. These findings underscore the need for tailored perioperative strategies and risk counseling.

背景：身体质量指数（BMI）与外科主动脉瓣置换术（SAVR）和经导管主动脉瓣置换术（TAVR）预后之间的关系尚不清楚。本研究评估了在全国代表性的主动脉瓣置换术队列中BMI与临床结果之间的微妙关系。方法分析2016-2021年全国住院患者样本中因选择性SAVR或TAVR入院的成人（≥18岁）。BMI分为体重过轻（20）、理想体重（20 - 30）、肥胖I级（30-34.9）、II级（35-39.9）和III级（≥40）。主要终点是住院死亡率。次要结局包括主要不良事件（MAE）、死亡率和并发症（如中风、血栓栓塞、心脏、呼吸、感染、肾脏）的组合。结果在103,000例患者中，61.2%的患者接受了TAVR。TAVR患者年龄较大(76岁vs. 64岁；p & lt;0.001)和更频繁的体重不足(3.1% vs. 1.5%；p & lt;0.001)，与SAVR患者相比。在TAVR中，BMI <；与理想BMI相比，20与更高的死亡率（AOR 2.99, 95% CI 1.16-7.74）和MAE （AOR 1.74, 95% CI 1.30-2.34）相关。肥胖并没有增加TAVR患者MAE的总发生率。在SAVR中，死亡率与BMI无关，但体重不足（AOR 2.05, 95% CI 1.33-3.15）和III级肥胖（AOR 1.34, 95% CI 1.09-1.65）与较高的MAE风险相关。结论BMI值越高，SAVR和TAVR的预后越差。体重过轻的患者在两种方法中都增加了风险，而严重肥胖的患者在SAVR中增加了MAE的风险。这些发现强调了量身定制围手术期策略和风险咨询的必要性。

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引用次数: 0

Surgical trainee education in benign anorectal disease: a scoping review 良性肛肠疾病的外科培训生教育：范围综述

IF 1.4 Q3 SURGERY

Surgery open science

Pub Date : 2025-06-01 DOI: 10.1016/j.sopen.2025.05.001

Eleanor G.R. Watson BSc (Hons), MD , Tony Y. Zhang BBMed , Hwa Ian Ong MBChB, FRACS , David M. Proud MBBS (Hons), FRACS , Helen M. Mohan PhD, FRCSI

Background

Benign anorectal diseases such as haemorrhoids, perianal abscesses and fistulas are prevalent and disabling conditions that can be difficult to diagnose and treat.

This review aims to evaluate current education for training doctors around these diseases to inform the revision and development of surgical curricula.

Materials and methods

A literature search was conducted in MEDLINE, Embase and Google Scholar and data from included articles were charted in a semi-structured table. Quantitative outcomes were presented using simple descriptive statistics. Qualitative data were analysed using a reflexive thematic analysis framework.

Results

Ten studies were included. Most education was centred around haemorrhoids and delivered in the format of lectures and simulations. Harnessing the benefits of both on-demand and in-person content was key to optimising education delivery. In simulation studies, low-fidelity models were generally sufficient to meet educational objectives. There was universal agreement that the purpose of education was to supplement or prepare for clinical exposure, rather than to replace or ‘bridge gaps’ in experience. Education was found to be most useful and relevant when delivered to junior surgical or non-surgical cohorts.

Conclusions

This review elucidates gaps in current literature on benign anorectal disease education and provides recommendations for the development and implementation of future education for surgical trainees. There is a need for education that addresses a broader range of anorectal conditions and has a greater focus on the retention and clinical translation of acquired knowledge and skills. Interventions should be designed to enhance clinical exposure and maintain relevance throughout training progression.

背景：良性肛肠疾病如痔疮、肛周脓肿和瘘管是常见的致残性疾病，很难诊断和治疗。本综述旨在评价目前医生围绕这些疾病的培训教育，为外科课程的修订和发展提供信息。材料与方法在MEDLINE、Embase和谷歌Scholar中进行文献检索，并将纳入文章的数据用半结构化表格绘制。定量结果采用简单的描述性统计。使用反身性专题分析框架对定性数据进行分析。结果纳入10项研究。大多数教育以痔疮为中心，以讲座和模拟的形式进行。利用点播和现场内容的优势是优化教育交付的关键。在模拟研究中，低保真度模型通常足以满足教育目标。人们普遍认为，教育的目的是补充或准备临床接触，而不是取代或“弥合经验差距”。教育被发现是最有用的和相关的，当提供给初级外科或非手术队列。结论本文综述了目前关于肛肠良性疾病教育的文献空白，并对今后外科培训生教育的制定和实施提出了建议。有必要开展针对更广泛的肛肠疾病的教育，并更加注重已获得的知识和技能的保留和临床转化。干预措施的设计应加强临床暴露，并在整个培训过程中保持相关性。

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引用次数: 0

Prevalence of recurrent nerve injury among esophageal cancer patients undergoing esophagectomy: A systematic review and meta-analysis 食管癌切除术患者复发性神经损伤的发生率：系统回顾和荟萃分析

IF 1.4 Q3 SURGERY

Surgery open science

Pub Date : 2025-05-30 DOI: 10.1016/j.sopen.2025.05.009

Prakasini Satapathy , Abhay M. Gaidhane , Nasir Vadia , Soumya V. Menon , Kattela Chennakesavulu , Rajashree Panigrahi , Ganesh Bushi , Mahendra Singh , Sanjit Sah , Awakash Turkar , S. Govinda Rao , Khang Wen Goh , Muhammed Shabil

Background

Esophageal cancer remains a major cause of cancer-related mortality worldwide, and esophagectomy is a primary curative treatment for localized disease. However, recurrent laryngeal nerve (RLN) injury is a common and impactful complication that can impair vocal cord function, increase aspiration risk, and hinder postoperative recovery. To quantify its prevalence and explore contributing factors, we conducted a systematic review and meta-analysis including 24 studies and 6015 patients. The overall pooled prevalence of RLN injury was 18.36 % (95 % CI, 11.50 %–28.00 %), with substantial heterogeneity (I² = 95.8 %). Subgroup analysis revealed a lower pooled prevalence in robot-assisted minimally invasive esophagectomy (RAMIE) at 13.39 % (95 % CI, 9.28 %–18.95 %) compared to 21.89 % (95 % CI, 12.92 %–34.62 %) in minimally invasive esophagectomy (MIE). Among surgical techniques, the McKeown approach had the highest RLN injury prevalence (26.32 %; 95 % CI, 15.59 %–40.85 %), whereas the Ivor Lewis approach demonstrated a notably lower rate (5.77 %; 95 % CI, 1.00 %–100.00 %). RLN injury was more frequent in studies from low-volume or early-learning curve centers, while high-volume single-center RAMIE cohorts showed both lower prevalence and reduced heterogeneity. Sensitivity analyses supported the robustness of these findings, and publication bias assessment indicated only minor asymmetry (LFK index −1.81). These results highlight the clinical importance of RLN injury and support the role of robotic-assisted techniques, surgical experience, and intraoperative neuromonitoring in mitigating risk. Standardized definitions and procedural training are essential to improving outcomes and reducing the burden of this complication.

食管癌仍然是世界范围内癌症相关死亡的主要原因，食管癌切除术是局部疾病的主要治疗方法。然而，喉返神经（RLN）损伤是一种常见且有影响的并发症，可损害声带功能，增加误吸风险，阻碍术后恢复。为了量化其患病率并探讨影响因素，我们对24项研究和6015例患者进行了系统回顾和荟萃分析。RLN损伤的总总患病率为18.36 %(95 % CI, 11.50 % -28.00 %)，具有很大的异质性（I2 = 95.8 %）。亚组分析显示，机器人辅助微创食管切除术（RAMIE）的总患病率为13.39 %(95 % CI, 9.28 % -18.95 %)，而微创食管切除术（MIE）的总患病率为21.89 %（95 % CI, 12.92 % -34.62 %）。在手术技术中，McKeown入路的RLN损伤发生率最高(26.32 %；95% % CI, 15.59 % -40.85 %)，而Ivor Lewis方法的发生率明显较低(5.77 %；95 % ci, 1.00 % -100.00 %)。RLN损伤在小容量或早期学习曲线中心的研究中更为常见，而大容量的单中心RAMIE队列显示出更低的患病率和更低的异质性。敏感性分析支持这些发现的稳健性，发表偏倚评估显示只有轻微的不对称性（LFK指数- 1.81）。这些结果强调了RLN损伤的临床重要性，并支持机器人辅助技术、手术经验和术中神经监测在降低风险方面的作用。标准化的定义和程序性培训对于改善结果和减轻这种并发症的负担至关重要。

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引用次数: 0

Systematic review and meta-analysis of Transanal Opening of Intersphincteric Space (TROPIS) versus conventional treatments for anal fistula 经肛门括约肌间隙（TROPIS）与传统治疗肛瘘的系统回顾和荟萃分析

IF 1.4 Q3 SURGERY

Surgery open science

Pub Date : 2025-05-30 DOI: 10.1016/j.sopen.2025.05.010

Yang-Tao Chen , Zhao-Chu Wang, Ya-Meng Xie, Xun Wang, Xu-Xiong Wu, Yang Li, Rong Shi, Jing Wang

Transanal Opening of Intersphincteric Space (TROPIS) has emerged as a promising surgical approach for anal fistula management over recent years. This meta-analysis comprehensively evaluates the comparative efficacy and safety of TROPIS versus conventional treatments through systematic analysis of 24 clinical studies involving 2813 patients. Through systematic searches across 7 major biomedical databases (including PubMed, EMBASE, and Chinese repositories) from inception to March 2024, we identified comparative studies assessing TROPIS against six established interventions: incision-thread-drawing, seton placement, LIFT, EAFR, fistulotomy, and incision-suture techniques. Pooled analysis demonstrated TROPIS achieved superior clinical outcomes, with a 3.15-fold higher total efficacy rate (95 % CI 1.22–8.13, p = 0.02) and 64 % lower complication risk compared to conventional methods (OR 0.28, 95 % CI 0.18–0.42, p < 0.00001). Sensitivity analyses confirmed result stability across study designs, while publication bias assessment via funnel plots and Egger's test revealed no significant distortion. Importantly, TROPIS maintained its advantage across various complication subtypes including incontinence (OR 0.31), infection (OR 0.27), and recurrence (OR 0.19). These findings establish TROPIS as a clinically superior alternative that significantly improves therapeutic outcomes while reducing procedure-related risks, suggesting its potential to become the new reference standard in anal fistula management. The consistent results across diverse patient populations and comparator procedures underscore the robustness of this evidence synthesis.

近年来，经肛门括约肌间隙开放术（TROPIS）已成为肛瘘治疗的一种很有前途的手术方法。本荟萃分析通过对涉及2813例患者的24项临床研究的系统分析，综合评价了TROPIS与常规治疗的比较疗效和安全性。通过对7个主要生物医学数据库（包括PubMed、EMBASE和中文数据库）从成立到2024年3月的系统检索，我们确定了比较研究，评估了TROPIS与六种已建立的干预措施：切口线绘制、seton放置、LIFT、EAFR、瘘切开术和切口缝合技术。合并分析显示，与传统方法相比，TROPIS获得了更好的临床结果，总有效率提高3.15倍（95% CI 1.22-8.13, p = 0.02），并发症风险降低64% (OR 0.28, 95% CI 0.18-0.42, p <；0.00001)。敏感性分析证实了研究设计结果的稳定性，而通过漏斗图和Egger检验进行的发表偏倚评估显示没有显著的失真。重要的是，TROPIS在包括尿失禁（OR 0.31）、感染（OR 0.27）和复发（OR 0.19）在内的各种并发症亚型中保持了优势。这些研究结果表明，TROPIS在临床上是一种优越的选择，可以显著改善治疗结果，同时降低手术相关风险，这表明它有可能成为肛瘘治疗的新参考标准。不同患者群体和比较程序的一致结果强调了这一证据综合的稳健性。

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引用次数: 0

Searching for bacteria within acute cholecystitis using next-generation sequencers 使用新一代测序仪寻找急性胆囊炎中的细菌

IF 1.4 Q3 SURGERY

Surgery open science

Pub Date : 2025-05-26 DOI: 10.1016/j.sopen.2025.05.006

Tomohiro Otsuka , Yoichi Ishizaki , Jiro Yoshimoto , Kenji Takamori , Shin Watanabe

Introduction

A biliary microbiome comprising flora within normal gallbladders was recently uncovered through analyses targeting the bacterial 16S ribosomal RNA (16S rRNA) gene, despite the gallbladder previously being regarded as a sterile environment. In the present study, we subjected bile samples from patients with acute cholecystitis to gene analysis targeting bacterial flora.

Methods

We targeted patients diagnosed as having Grade I or Grade II acute cholecystitis (in accordance with the Tokyo Guidelines 2018 established by the Japanese Society of Hepato-Biliary-Pancreatic Surgery) who underwent laparoscopic cholecystectomy within 24 h of diagnosis at Juntendo University Urayasu Hospital between July 2021 and January 2024 for evaluation. We drew bile sample from the gallbladder of each patient to confirm the presence of biliary bacterial flora, using both standard bacteriology (culture test) and 16S rRNA gene sequence.

Results

Of the 29 samples, 15 yielded cultures positive for bacterial flora, and gene analysis revealed the presence of bacterial biliary flora in all 14 samples that had tested negative in standard bacteriology. Considering the bacterial flora of a normal gallbladder without lesions as “normal flora,” bacteria other than normal flora—Propionibacterium spp., Coprococcus spp., Prevotella spp., Sediminibacterium spp., and Collinesella spp.—were detected in 25 of the 29 cases (86 %).

Conclusions

Bacteria not detected in non-inflammatory gallbladders such as Propiobacterium spp., Coprococcus spp., Prevotella spp., Sediminibacterium spp., and Collinesella spp. may play a role in the mechanism underlying development of acute cholecystitis.

尽管胆囊以前被认为是无菌环境，但最近通过针对细菌16S核糖体RNA （16S rRNA）基因的分析，发现了正常胆囊中包含菌群的胆道微生物组。在本研究中，我们对急性胆囊炎患者的胆汁样本进行了针对细菌菌群的基因分析。方法：研究对象为诊断为I级或II级急性胆囊炎的患者（根据日本肝胆胰外科学会制定的2018年东京指南），这些患者于2021年7月至2024年1月在俊天道大学浦安医院诊断后24小时内行腹腔镜胆囊切除术进行评估。我们从每位患者的胆囊中抽取胆汁样本，使用标准细菌学（培养试验）和16S rRNA基因序列来确认胆道菌群的存在。结果29份样本中，15份培养菌群呈阳性，基因分析显示14份标准细菌学检测阴性的样本中均存在细菌胆道菌群。考虑到没有病变的正常胆囊的细菌菌群为“正常菌群”，29例患者中有25例（86%）检测到正常菌群以外的细菌——丙酸杆菌、粪球菌、普雷沃氏菌、沉积杆菌和Collinesella。结论非炎性胆囊中未检出的细菌如丙杆菌、粪原球菌、普雷沃氏菌、沉积杆菌和大肠杆菌可能在急性胆囊炎的发生机制中起作用。

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引用次数: 0

Pancreaticoduodenectomy on soft-embalmed human cadavers according to Dodge – a pilot feasibility report 根据道奇的试点可行性报告，对软防腐尸体进行胰十二指肠切除术

IF 1.4 Q3 SURGERY

Surgery open science

Pub Date : 2025-05-21 DOI: 10.1016/j.sopen.2025.05.005

Dariya Jaeger , Eric Hinrichs , Ralf Schoppe , Gebhard Reiss , Georg Feigl , Benno Mann

Objective

Pancreaticoduodenectomy (PD) is one of the most complex procedures in abdominal surgery. Nowadays, it is very difficult for novice surgeons to learn the procedure of PD on living patients. New concepts are needed to improve the surgical training of PD, comparable to education in the operating room.

Method

We investigated the feasibility of performing PD on a soft embalmed human cadaver using the Dodge preservation technique, considering all operative steps. Surgery was performed by a certified expert. The settings corresponded to the conditions of the operating room with the original surgical instruments and sutures. Upon completion of the PD, feedback in the form of a comprehensive questionnaire was obtained from the expert by evaluating all relevant operational steps in terms of realism using a 5 point Likert scale.

Results

PD was performed successfully by the expert. The results showed very good feasibility for PD on the used Dodge embalmed cadaver (DeC). The expert confirmed a realistic surgical performance similar to real-life conditions, with good color contrast, clearly visible tissue layers for a layered preparation, and a great result for the reconstruction part of the anastomoses.

Conclusions

New educational methods are needed to improve surgical training of PD. Hands-on training of PD performed on DeC enables a realistic surgical experience and offers a promising educational method for training in pancreatic surgery.

目的胰十二指肠切除术（PD）是腹部外科最复杂的手术之一。目前，新手外科医生学习活体PD的操作是非常困难的。需要新的理念来提高PD的手术培训，堪比手术室的教育。方法综合考虑各操作步骤，探讨采用Dodge保存技术对软防腐尸体进行PD的可行性。手术是由一位有资格的专家进行的。设置符合手术室条件，使用原始手术器械和缝合线。PD完成后，通过使用5分李克特量表评估所有相关操作步骤的真实性，从专家那里获得一份全面问卷的反馈。结果专家成功执行了spd。结果表明，在旧道奇防腐尸体（DeC）上应用PD具有良好的可行性。专家确认了与现实生活条件相似的逼真手术表现，具有良好的颜色对比度，分层准备时清晰可见的组织层，以及吻合器重建部分的良好效果。结论需要新的教育方法来提高PD的手术培训水平。在DeC上进行PD的实践培训可以提供真实的手术经验，并为胰腺手术培训提供了一种有前途的教育方法。

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引用次数: 0

Video-based learning for basic surgical skills - A randomized trial 基于视频的基本手术技能学习——一项随机试验

IF 1.4 Q3 SURGERY

Surgery open science

Pub Date : 2025-05-15 DOI: 10.1016/j.sopen.2025.05.003

I. Dantas , I. Jorge , A. Nicolau , M. Vales , C. Coutinho , S. Rodrigues , P. Febra , V.N. Lopes

Objective

The authors sought to evaluate how video-based learning compares to traditional learning method in basic surgical skills.

Design

Prospective, randomized and blinded case-control study.

Setting

Faculty of Medicine, University of Porto.

Participants and methods

Fifty medical students were randomized into two groups: traditional learning (in-person course) and video-based learning. Four sutures were taught to both groups: simple interrupted, cruciate mattress, horizontal mattress and vertical mattress sutures.

A first evaluation occurred following the learning sessions, and a retention evaluation was performed two weeks later.

Both groups were compared on performance quality (using a modified Objective Structured Assessment of Technical Skills scale (mOSATS)), time to complete the procedure, and participant satisfaction and self-evaluation (using a Likert-like questionnaire). The frequency and duration of autonomous training by the video-based learning group was documented.

Results

Performance quality was similar in the first evaluation, except for the horizontal [25.88 (SD (Standard Deviation) 3.58) vs 28.28 (SD 3.79), p = 0.04] and vertical mattress sutures [24.14 (SD 3.59) vs 28.44 (SD 3.69), p < 0.01], where the video-based learning group got higher mOSATS scores. In the retention evaluation, the video-based learning group demonstrated higher mOSATS ratings.

The time spent learning with videos was 45 min longer [median in hours: 2:15:30 (IQR (Interquartile Range) 2:17:44)] than the in-person course duration. Overall, the traditional learning group completed sutures faster (p < 0.01).

Conclusion

Video-based learning may be an effective alternative to traditional teaching of basic surgical skills, in performance quality and retention, offering better resource allocation and cost savings.

目的评价基于视频的外科基本技能学习方法与传统学习方法的比较。前瞻性、随机、盲法病例对照研究。波尔图大学医学院。参与者和方法50名医学生随机分为两组：传统学习（面对面课程）和基于视频的学习。两组分别教授四种缝合术：简单间断缝合术、十字缝合术、水平缝合术和垂直缝合术。第一次评估在学习课程之后进行，两周后进行记忆力评估。比较两组的表现质量（使用改进的客观结构化技术技能评估量表（mOSATS））、完成程序的时间、参与者满意度和自我评价（使用李克特式问卷）。记录了视频学习组自主训练的频率和持续时间。结果除水平缝[25.88 （SD (Standard Deviation) 3.58）对28.28 (SD 3.79), p = 0.04]和垂直缝[24.14 （SD 3.59）对28.44 (SD 3.69), p <；0.01]，其中视频学习组获得更高的mOSATS分数。在记忆评估中，视频学习组表现出更高的mOSATS评分。视频学习时间比现场学习时间长45分钟[小时中位数：2:15:30（四分位间距：2:17:44）]。总体而言，传统学习组完成缝合的速度更快(p <；0.01)。结论视频教学可有效替代传统的外科基本技能教学，提高教学效果，提高教学质量，节约教学成本。

{"title":"Video-based learning for basic surgical skills - A randomized trial","authors":"I. Dantas , I. Jorge , A. Nicolau , M. Vales , C. Coutinho , S. Rodrigues , P. Febra , V.N. Lopes","doi":"10.1016/j.sopen.2025.05.003","DOIUrl":"10.1016/j.sopen.2025.05.003","url":null,"abstract":"<div><h3>Objective</h3><div>The authors sought to evaluate how video-based learning compares to traditional learning method in basic surgical skills.</div></div><div><h3>Design</h3><div>Prospective, randomized and blinded case-control study.</div></div><div><h3>Setting</h3><div>Faculty of Medicine, University of Porto.</div></div><div><h3>Participants and methods</h3><div>Fifty medical students were randomized into two groups: traditional learning (in-person course) and video-based learning. Four sutures were taught to both groups: simple interrupted, cruciate mattress, horizontal mattress and vertical mattress sutures.</div><div>A first evaluation occurred following the learning sessions, and a retention evaluation was performed two weeks later.</div><div>Both groups were compared on performance quality (using a modified Objective Structured Assessment of Technical Skills scale (mOSATS)), time to complete the procedure, and participant satisfaction and self-evaluation (using a Likert-like questionnaire). The frequency and duration of autonomous training by the video-based learning group was documented.</div></div><div><h3>Results</h3><div>Performance quality was similar in the first evaluation, except for the horizontal [25.88 (SD (Standard Deviation) 3.58) vs 28.28 (SD 3.79), <em>p</em> = 0.04] and vertical mattress sutures [24.14 (SD 3.59) vs 28.44 (SD 3.69), <em>p</em> < 0.01], where the video-based learning group got higher mOSATS scores. In the retention evaluation, the video-based learning group demonstrated higher mOSATS ratings.</div><div>The time spent learning with videos was 45 min longer [median in hours: 2:15:30 (IQR (Interquartile Range) 2:17:44)] than the in-person course duration. Overall, the traditional learning group completed sutures faster (<em>p</em> < 0.01).</div></div><div><h3>Conclusion</h3><div>Video-based learning may be an effective alternative to traditional teaching of basic surgical skills, in performance quality and retention, offering better resource allocation and cost savings.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":"26 ","pages":"Pages 94-106"},"PeriodicalIF":1.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144107461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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