Melhoria das habilidades laparoscópicas de residentes de ginecologia e obstetrícia após treinamento em simulador
Introduction: laparoscopy is currently consolidated as a minimally invasive surgical technique, presenting, compared to analogous conventional surgeries, gains in postoperative results, being standard procedure for several surgeries. Laparoscopic training has peculiarities that make it difficult...
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| Formato: | Dissertação |
| Idioma: | pt_BR |
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Brasil
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| Endereço do item: | https://repositorio.ufrn.br/jspui/handle/123456789/28315 |
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| Resumo: | Introduction: laparoscopy is currently consolidated as a minimally invasive surgical
technique, presenting, compared to analogous conventional surgeries, gains in
postoperative results, being standard procedure for several surgeries. Laparoscopic
training has peculiarities that make it difficult to acquire its skills and it has a long
learning curve. Objective: to evaluate whether laparoscopic simulator training is
effective for the development of laparoscopic skills in gynecology and obstetrics
residents. Methodology: prospective, non-randomized, quasi-experimental study in
which participants were trained in laparoscopic dominant hand suturing, using the
gladiator technique and the laparoscopic E-Knot model with Neoderma® disc. The
training consisted of dialogued exposure and two-hour hands-on. The Global
Operative Assessment of Laparoscopic Skills (GOALS) was used as an assessment
tool. Participants, in addition to performing their self-assessments, were examined by
two independent evaluators. The data obtained were analyzed with nonparametric
statistical techniques by Wilcoxon and Friedman. Data collection was performed at the
Maternidade Escola Januário Cicco / Universidade Federal do Rio Grande do Norte
(MEJC/UFRN), from January to February 2019. Results: the sample consisted of 14
residents, but one was excluded for not completing the training. Statistically significant
laparoscopic skill gains were demonstrated by the Wilcoxon test, with a mean
difference of 2.5 to 5.167 points in the total post-intervention GOALS score compared
to the pre-training assessment. All items in the score reached statistical significance,
except for tissue handling for one of the evaluators. The inter-rater reliability analyzed
by the Friedman test in relation to the pre-intervention GOALS showed no significant
differences, but for the post-intervention GOALS, they reached p-value <0.05 for all
evaluated items except tissue handling. Conclusion: training in intracorporeal suture
simulator by the Armando Romeo technique was effective for laparoscopic skills gains
evaluated by GOALS. |
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