Assessment of the educational approaches for robotic minimally invasive esophagectomy

IF 0.3 4区 医学 Q4 SURGERY
Mohammad Abdallat, Jon O. Wee
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引用次数: 0

Abstract

: Esophagectomy is a key element in the trimodal therapy for esophageal cancer. The advancement in minimally invasive and robotic technique have reduced the morbidity and mortality associated with open esophagectomy while improving the postoperative quality of life without affecting the oncological outcomes. This has reduced operative length of stay and increased the chance of patient receiving adjuvant systemic therapy. Recently, the number of esophagectomies performed minimally invasively have surpassed open esophagectomy. However, implementation of innovative surgical techniques always faces a learning curve that delays its adaptation. Anastomotic leaks can increase during the learning curve for both conventional minimally invasive and robotic assisted minimally invasive esophagectomy. Multiple authors have documented the number of esophagectomies needed to achieve proficiency or overcome the learning curve morbidity. This review focus on complete video assisted approaches (laparoscopic, thoracoscopic and robotic approaches). Utilizing a trans-hiatal or a hybrid approach can be considered minimally invasive by some but it’s outside the scope of this review. Determining the ideal educational program is challenging due to the complexity and variety of required skills in both the abdomen and chest. The absence of a standardized and validated robotic esophagectomy curriculum demonstrates the need for a thoughtful approach to prepare trainee and surgeons to adapt these approaches. Establishing dedicated training centers supervised by surgical and academic societies may help surgeons from lower volume centers adapt these techniques.
机器人微创食管切除术教学方法的评价
食管切除术是食管癌三模式治疗的关键。微创技术和机器人技术的进步降低了开放式食管切除术的发病率和死亡率,同时在不影响肿瘤预后的情况下提高了术后生活质量。这减少了手术时间,增加了患者接受辅助全身治疗的机会。最近,微创食管切除术的数量已经超过了开放式食管切除术。然而,创新外科技术的实施总是面临一个学习曲线,延迟其适应。在常规微创和机器人辅助微创食管切除术的学习曲线中,吻合口泄漏会增加。多名作者记录了达到熟练或克服学习曲线发病率所需的食管切除术的数量。本综述的重点是完整的视频辅助入路(腹腔镜、胸腔镜和机器人入路)。一些人认为使用跨裂孔或混合入路是微创的,但这超出了本综述的范围。由于腹部和胸部所需技能的复杂性和多样性,确定理想的教育计划是具有挑战性的。标准化和有效的机器人食管切除术课程的缺乏表明需要一个深思熟虑的方法来准备实习生和外科医生适应这些方法。在外科和学术协会的监督下建立专门的培训中心可以帮助来自低容量中心的外科医生适应这些技术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
0.40
自引率
0.00%
发文量
13
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