Our Summary

This research paper suggests that surgical trainees (known as “residents”) should be tested on their laparoscopic surgery skills earlier in their training. Laparoscopic surgery is a type of minimally invasive procedure that uses small incisions and a camera to perform operations. The study looked at the test results of 42 residents who took the Fundamentals of Laparoscopic Surgery (FLS) test, a standard exam for these skills, between 2011 and 2016 at the Washington University in St. Louis School of Medicine. All the residents passed the test on their first try, no matter what year of their training they were in.

In addition, the study found that residents are performing more laparoscopic surgeries earlier in their residency, and that the number of these surgeries has increased over time. For example, residents who graduated in 2012 or 2013 performed 229 laparoscopic surgeries, compared to 267 for those who graduated between 2014 and 2016. Current residents also performed more laparoscopic surgeries in their first two years of training than previous residents did.

The researchers concluded that because of the increase in laparoscopic surgeries, the FLS test should be given earlier in residency to assess trainees’ knowledge and skills before they begin performing more complex laparoscopic surgeries.

FAQs

  1. What is laparoscopic surgery and how is it being incorporated into surgical training?
  2. What is the Fundamentals of Laparoscopic Surgery (FLS) test and when is it typically administered to surgical trainees?
  3. According to the study, has the number of laparoscopic surgeries performed by residents increased over time?

Doctor’s Tip

A doctor might tell a patient that laparoscopic surgery is a minimally invasive procedure that typically results in less pain, shorter recovery time, and smaller scars compared to traditional open surgery. They may also advise the patient to follow all pre-operative instructions, such as fasting before the surgery and avoiding certain medications, to ensure a successful procedure. Additionally, the doctor may recommend that the patient stay active and maintain a healthy diet to aid in the recovery process. Lastly, the doctor may emphasize the importance of attending all follow-up appointments and contacting them immediately if there are any concerns or complications post-surgery.

Suitable For

Patients who are typically recommended for laparoscopic surgery include those with conditions such as gallbladder disease, appendicitis, hernias, and certain types of cancer. Laparoscopic surgery is often preferred for these patients because it is less invasive, resulting in shorter recovery times, less pain, and fewer complications compared to traditional open surgery. Additionally, laparoscopic surgery can also be used for diagnostic purposes, such as exploring the abdomen for sources of pain or other symptoms.

Timeline

Before laparoscopic surgery:

  1. Patient meets with a surgeon to discuss the need for surgery and the procedure itself.
  2. Patient undergoes pre-operative testing and evaluation to ensure they are a good candidate for laparoscopic surgery.
  3. Patient receives instructions on how to prepare for surgery, including fasting and stopping certain medications.
  4. On the day of surgery, patient arrives at the hospital or surgical center and is prepped for the procedure.

After laparoscopic surgery:

  1. Patient wakes up in the recovery room and is monitored closely by medical staff.
  2. Patient may experience some pain and discomfort at the incision sites, but this is typically managed with pain medication.
  3. Patient is encouraged to start moving around as soon as possible to prevent blood clots and promote healing.
  4. Patient is discharged from the hospital or surgical center once they are stable and able to care for themselves at home.
  5. Patient follows post-operative instructions for wound care, pain management, and activity restrictions.
  6. Patient attends follow-up appointments with their surgeon to monitor their recovery and address any concerns.

What to Ask Your Doctor

Some questions a patient should ask their doctor about laparoscopic surgery include:

  1. What specific procedure will be performed using laparoscopic surgery?
  2. What are the potential risks and complications associated with this type of surgery?
  3. How long will the recovery time be after the surgery?
  4. What is the success rate of this type of surgery for my condition?
  5. Are there any alternative treatment options to consider?
  6. How experienced is the surgical team in performing laparoscopic surgeries?
  7. Will there be any scarring from the incisions made during the surgery?
  8. How long will I need to stay in the hospital after the surgery?
  9. What steps can I take to prepare for the surgery and improve my recovery process?
  10. What post-operative care will be required, such as follow-up appointments or physical therapy?

Reference

Authors: Cullinan DR, Schill MR, DeClue A, Salles A, Wise PE, Awad MM. Journal: J Surg Educ. 2017 Nov-Dec;74(6):e51-e54. doi: 10.1016/j.jsurg.2017.07.017. Epub 2017 Jul 27. PMID: 28756968