Development Of Skills in Laparoscopic Surgery
The training of the surgeon in laparoscopic surgery carried out from the theoretical, practical, and clinical fields. This includes knowledge of the apparatus and pathophysiology. The development of skills in dissection and suture techniques in the simulator and the experimental animal. And, finally, in the operating room, initially as assistants to progress until the complete performance of the intervention. Laparoscopic Trainer.
Laparoscopic Training mockup with Laparoscopic Trainer is a sensible choice.
This approach is applicable to both trained surgeons and residents in training. Hospitals and surgery departments responsible for the training of specialists must guarantee adequate teaching of laparoscopic surgery to new surgeons so that this is a common technique and not an exceptional technique.
Modifications of the movement of the hands in laparoscopic surgery
The first difficulty perceived before a television screen in laparoscopic surgery is the impossibility of coordinating movements. Gestures made with one hand appear uncoordinated. And this accentuates when he tries to make maneuvers for which he needs to use both hands. It seems as if there is a gap between each of them. Laparoscopic Trainer.
This fact is even more surprising when it verifies that the movements that the surgeon performs routinely. And automatically in open surgery require great concentration in laparoscopy. So, they perform with great difficulty despite the slowness that instinctively applies.
Reversal Of Movements
Another surprising fact is the existence of a reversal of movements. Since those that executes with one hand are exactly opposite to those that wants to be carries out on screen. In open surgery, the surgeon knows that when he points his hand upwards. The scalpel or the instrument in his hand directs in the same direction. And when his hand points to the right, instrument moves exactly to the right, that is: in the same direction. Laparoscopic Trainer.
In laparoscopy, exactly the opposite occurs. When the hand or the instrument goes up, on the screen the instrument goes down. And when the hand goes to the right, the instrument goes to the left. Thus, in laparoscopy the movements that executes are inverse.
Muscular Contraction
It is also notorious that motility also alters. regulated to the extent by the different types of sensitivities, but above all by the deep one. This loss of information provided by the sensitivities means that muscle contraction not carries out in a continuous and harmonious manner.
Position Fixity
Altering the so-called position fixity or static fixity provided by the tone of all the muscles. Both agonists and antagonists, that intervene in a move. Giving rise to alterations in prismatic motility or biodynamic motility of Hes. In practice, it specifies in the difficulty to perform fine movements, necessary to dissect structures and specially to make knots.
All this is more remarkable because these gestures perform routinely, automatically, and one could almost say unconsciously in open surgery. Laparoscopic Trainer.
Learning Period of Skills Assimilates
From the foregoing, it follows that laparoscopic surgery requires a learning period in which a series of skills assimilates, such as handling lighting devices, cameras, insufflators, etc. But, in addition, a period of learning surgical skills needs.
This only acquires through the close tutoring of the student by a person who has said technique. So that with the repetition of gestures and maneuvers they incorporates automatically when doing routine in laparoscopy.
Enormous Publications Surgical World
Given the enormous explosion that this type of surgery has brought about in our surgical world. We believe that to get an idea of how laparoscopic surgery has developed. It would be good to know the number of published cases. And, at the same time, study the different courses of learning that imparts. Laparoscopic Trainer.
Publications In Congress and National Meetings
We studied all the communications presented at the meetings. And congresses of the Association of Surgeons during the years 1992, 1993 and 1994. As these were the first years of establishment of this approach. Although the Association of Surgeons is not the only Surgical Society.
Indicator Parameter of Laparoscopic Activity
It is, however, the one that holds the largest and most publicized meetings. Therefore, we have believed that it is a good indicator parameter to reflect the laparoscopic activity of the entire country. The result of our search expresses.
Thus, during these 3 years, 7509 cholecystectomies, 838 appendectomies and 112 colectomies reports. Only at the congresses and meetings of the Association of Surgeons.
Regarding publications, we reviewed all the articles on laparoscopic surgery published during the years in the journal.
- The first works appear in 1992 in several five 5-9, all of them referring to cholelithiasis, with the performance of 406 cholecystectomies.
- From 1993, 7 papers 10-16 publishes, reporting the performance of 300 cholecystectomies and 8 colectomies.
- As in 1994 the works multiplied, understanding something clearly at last 18 17-34 in which 1,240 cholecystectomies, 268 appendectomies and 86 inguinal herniorrhaphies reported.
In total, considering the interventions mentioned in communications to congresses and those published, it said that during the 3 years studied, 9455 cholecystectomies, 437 inguinal hernias and 120 colectomies performed.
Conclusion
This method works for both trained surgeons and trained assistants. Hospitals and surgical departments that train specialists must ensure that new surgeons give appropriate laparoscopic guidance. So, this is a general technique, not a specific technique.
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