外科理论与实践

外科理论与实践 ›› 2025, Vol. 30 ›› Issue (2): 132-137.doi: 10.16139/j.1007-9610.2025.02.07

• 论著 • 上一篇    下一篇

进阶整合式腹腔镜模拟培训课程提升外科住院医师腹腔镜腹膜缝合技术的队列研究

蔡正昊, 宋海勤*, 孙晶, 薛佩, 张鲁阳, 吴超, 洪希周, 程兮, 张森, 郑民华, 臧潞, 潘睿俊(), 李健文(), 冯波()   

  1. 上海交通大学瑞金临床医学院外科学教研室 上海交通大学医学院附属瑞金医院普外科 上海市微创外科临床医学中心，上海 200025
  • 收稿日期:2024-10-25 出版日期:2025-03-25 发布日期:2025-07-07
  • 通讯作者: 冯波，E-mail: fengbo2022@163.com；
    潘睿俊，E-mail: prj11522@rjh.com.cn；
    李健文，E-mail: ljw10499@rjh.com.cn
  • 作者简介:*共同第一作者
  • 基金资助:
    上海交通大学“交大之星”计划医工交叉研究基金(YG2023QNB07);上海市中西医结合学会医学工程专业委员会课题研究专项基金重点项目(YG202313);上海市2023年度创新医疗器械应用示范项目(23SHS03000-02);上海市科学技术委员会2022年度“科技创新行动计划”生物医药科技支撑专项项目(22S31904000)

Best essential surgical technique training course to improve surgical residents′ laparoscopic peritoneal suturing skills: a cohort study

CAI Zhenghao, SONG Haiqin*, SUN Jing, XUE Pei, ZHANG Luyang, WU Chao, HONG Hiju, CHENG Xi, ZHANG Sen, ZHENG Minhua, ZANG Lu, PAN Ruijun(), LI Jianwen(), FENG Bo()   

  1. Department of Surgery Teaching, Ruijin Clinical School, Shanghai Jiao Tong University; Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Minimally Invasive Surgery Center, Shanghai 200025, China
  • Received:2024-10-25 Online:2025-03-25 Published:2025-07-07

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摘要：

目的：探究进阶整合式腹腔镜模拟培训（best essential surgical technique training, BEST）课程对提升外科住院医师腹腔镜腹膜缝合技术的教学效果。方法：BEST课程为进阶整合二段式，一阶段采用简易腔镜培训系统和简单模具进行培训。二阶段采用进阶腔镜培训系统结合3D腹腔镜以及动物离体模型进行培训。其中二阶段培训中包含腹腔镜缝合技术的培训内容。选取2021年8月—2024年7月于我院胃肠疝外科进行国家级规范化培训（第二年）的外科住院医师作为研究对象，根据其是否曾接受过BEST课程分为试验组和对照组。外科住院医师于胃肠疝外科培训期间在带教老师监督指导下完成2例腹腔镜腹膜缝合操作。比较两组腹膜缝合的手术时间、缝合质量、独立完成率等指标。 结果：本研究共纳入33名外科住院医师（试验组19名，对照组14名），共完成66例腹腔镜腹膜缝合操作（试验组38例，对照组28例）。试验组腹膜缝合操作时间少于对照组（15.7 min 比 17.5 min, P=0.025）。试验组缝合质量优于对照组（P=0.023）。试验组均由住院医师独立完成腹膜缝合，而对照组有3例（10.7%）由带教老师协助完成腹膜缝合，独立完成率差异有统计学意义（P=0.039）。结论：BEST课程有助于提升外科住院医师腹腔镜腹膜缝合技术，值得在外科住院医师规范化培训中推广。

关键词: 进阶整合式腹腔镜模拟培训, 外科住院医师规范化培训, 腹腔镜模拟教学, 腹膜缝合

Abstract:

Objective To explore the effectiveness of an integrated laparoscopic simulation training course (best essential surgical technique training, BEST) in enhancing laparoscopic peritoneal suturing techniques in surgical residents.Methods As an integrated two-stage program, the BEST course applied basic laparoscopic training system with simple molds in phase Ⅰ training, and then adopted advanced laparoscopic training system, 3D Laparoscope and ex-vivo animal models in phase Ⅱ training. The laparoscopic suturing techniques were practiced in phase Ⅱ training. From August 2021 to July 2024, surgical residents in the second year of the national standardized training program were divided into pilot and control groups based on whether they had undergone the BEST course. Two cases of laparoscopic peritoneal suture were performed by the surgical residents under supervision in the department of gastrointestinal surgery. The operative time, quality of suture, and independent completion rate were compared between the two groups.Results A total of 33 surgical residents (19 in pilot group and 14 in control group) were included in this study, and a total of 66 cases of laparoscopic peritoneal suture were performed (38 in pilot group and 28 in control group). The operative time was significantly shorter in pilot group than that in control group (15.7 min vs. 17.5 min, P=0.025). The quality of suture was significantly better in pilot group compared to control group (P=0.023). In pilot group, all peritoneal sutures were performed by residents independently, whereas in control group, 3 cases (10.7%) were assisted by the supervisor, and the independent completion rate was different significantly (P=0.039).Conclusions The BEST course can help improve surgical residents′ laparoscopic peritoneal suturing techniques and could be promoted in the national standardized training program for surgical residents.

Key words: Best essential surgical technique training(BEST), Standardized training program for surgical residents, Laparoscopic simulation training, Peritoneal suturing

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