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      Training efficacy of robotic duct-to-mucosa pancreaticojejunostomy simulation using silicone models for surgical fellows

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          Abstract

          Purpose

          In the era of minimally invasive surgery (MIS), robotic pancreatoduodenectomy (PD) is actively performed, and clinical fellows need to thoroughly prepare for MIS-PD during the training process. Although pancreaticojejunostomy (PJ) is a difficult anastomosis that requires repeated practice, there are obstacles preventing its practice that concerns patient safety and limited time in the actual operating room. This study evaluated the efficacy of simulation-based training of robotic duct-to-mucosa PJ using pancreatic and intestinal silicone models using a scoring system.

          Methods

          Three pancreatobiliary clinical fellows who had never performed a real robotic PJ participated in this study. Each trainee, who was well acquainted with master’s video created by a senor surgeon, performed the robotic PJ procedures 9 times, and 3 independent pancreatobiliary surgeons assessed the videos and analyzed the scores using a blind method.

          Results

          The mean robotic PJ times for the 3 trainees were 42.8 and 29.1 minutes for the first and 9th videos, respectively. The mean score was 13.8 (range, 6–17) for the first video and 17.7 (range, 15–19) for the 9th video. When comparing earlier and later attempts, the PJ time decreased significantly (2,201.67 seconds vs. 2,045.50 seconds, P = 0.007), whereas test scores increased significantly (total score 14.22 vs. 16.89, P = 0.011).

          Conclusion

          This robotic education system will help pancreatobiliary trainees overcome the learning curves efficiently and quickly without raising ethical concerns associated with animal models or direct practice with human subjects. This will be of practical assistance to trainees preparing for MIS-PD.

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          Most cited references16

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          Laparoscopic versus open pancreatoduodenectomy for pancreatic or periampullary tumours (LEOPARD-2): a multicentre, patient-blinded, randomised controlled phase 2/3 trial

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            Virtual reality training in laparoscopic surgery: A systematic review & meta-analysis

            Laparoscopic surgery requires a different and sometimes more complex skill set than does open surgery. Shortened working hours, less training times, and patient safety issues necessitates that these skills need to be acquired outside the operating room. Virtual reality simulation in laparoscopic surgery is a growing field, and many studies have been published to determine its effectiveness.
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              • Article: not found

              Learning curve of laparoscopic and robotic pancreas resections: a systematic review

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                Author and article information

                Journal
                Ann Surg Treat Res
                Ann Surg Treat Res
                ASTR
                Annals of Surgical Treatment and Research
                The Korean Surgical Society
                2288-6575
                2288-6796
                January 2024
                28 December 2023
                : 106
                : 1
                : 45-50
                Affiliations
                [1 ]Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
                [2 ]Department of Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
                [3 ]Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.
                [4 ]Department of Surgery, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea.
                Author notes
                Corresponding Author: Jin-Young Jang. Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea. Tel: +82-2-2072-2194, Fax: +82-2-741-2194, jangjy4@ 123456snu.ac.kr
                Author information
                https://orcid.org/0000-0002-3171-2540
                https://orcid.org/0000-0003-0456-7824
                https://orcid.org/0000-0001-6587-9579
                https://orcid.org/0000-0002-1142-1842
                https://orcid.org/0000-0002-9339-930X
                https://orcid.org/0000-0002-4827-7805
                https://orcid.org/0000-0003-3312-0503
                Article
                10.4174/astr.2024.106.1.45
                10774700
                e8483584-84b5-43a2-8222-d5749b7de44e
                Copyright © 2024, the Korean Surgical Society

                Annals of Surgical Treatment and Research is an Open Access Journal. All articles are distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 29 August 2023
                : 11 October 2023
                : 26 October 2023
                Categories
                Original Article
                Hbp

                simulation training,professional education,robotics,pancreaticojejunostomy,physical education and training

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