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HPB (Oxford). 2017 Mar;19(3):234-245. doi: 10.1016/j.hpb.2017.01.016. Epub 2017 Feb 10.

Training in Minimally Invasive Pancreatic Resections: a paradigm shift away from "See one, Do one, Teach one".

Author information

1
University of Pittsburgh Medical Center, Division of Surgical Oncology, Pittsburgh, PA, USA. Electronic address: hoggme@upmc.edu.
2
Academic Medical Center, Amsterdam, The Netherlands.
3
Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland.
4
University Hospital of Graz, Graz, Austria.
5
Methodist Health System, Dallas, TX, USA.
6
Emory University, Department of Surgery, Atlanta, GA, USA.
7
Beth Israel Deaconess Medical Center, Pancreas and Liver Institute, Boston, MA, USA.
8
Lewis Katz School of Medicine at Temple University, Department of Surgery, Philadelphia, PA, USA.
9
University of Michigan, Division of Minimally Invasive Surgery, Ann Arbor, MI, USA.
10
University of Pennsylvania, Philadelphia, PA, USA.
11
University of Pittsburgh Medical Center, Division of Surgical Oncology, Pittsburgh, PA, USA.
12
Portland Providence Cancer Institute, Liver and Pancreas Surgery, Portland, OR, USA.
13
Mayo Clinic, Jacksonville, FL, USA.
14
McGill University, Montreal, Canada.
15
Mayo Clinic, Rochester, MN, USA.
16
Emory University, Atlanta, GA, USA.
17
Portland Cancer Center, Portland, OR, USA.
18
UPMC, Pittsburg, PA, USA.
19
Hospital das Clínicas, Faculdade de Medicina da USP, Hospital Sírio Libanês, Sao Paulo, Brazil.
20
Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
21
Oredale Di Cisanello, Divisione Di Chirugia General, Pisa, Italy.
22
The University of Dublin, Trinity College, Tallaght, Dublin, Ireland.
23
Oslo University Hospital, Oslo, Norway.
24
Seoul National University Bundang Hospital, SeongNam si, South Korea.
25
GEM Hospital & Research Center, Coimbatore, Tamil Nadu, India.
26
Tata Memorial Centre, Parel, Mumbai, India.
27
Iwate Medical University, Iwate, Japan.

Abstract

BACKGROUND:

Increased incorporation of minimally invasive pancreatic resections (MIPR) has emerged into hepato-pancreato-biliary practice, however, no standardization exists for its safe adoption. Novel strategies are presented for dissemination of safe MIPR.

METHODS:

An international State-of-the-Art conference evaluating multiple aspects of MIPR was conducted by a panel of pancreas experts in Sao Paulo, Brazil on April 20, 2016. Training and education issues were discussed regarding the introduction of novel strategies for safe dissemination of MIPR.

RESULTS:

The low volume of pancreatic resections per institution poses a challenge for surgeons to overcome their MIPR learning curve without deliberate training. A mastery-based simulation and biotissue curriculum can improve technical proficiency and allow for training of surgeons before the operating room. Video-based platforms allow for performance reporting and feedback necessary for coaching and surgical quality improvement. Centers of excellence with training involving a standardized approach and proctorship are important concepts that can be utilized in various formats internationally.

DISCUSSION:

Surgical volume is not sufficient to ensure quality and patient safety in MIPR. Safe adoption of these complex procedures should consider innovative mastery-based training outside of the operating room, novel video based coaching techniques and prospective reporting of patient data and outcomes using standardized definitions.

PMID:
28190709
DOI:
10.1016/j.hpb.2017.01.016
[Indexed for MEDLINE]
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