Who should do NOTES? Initial endoscopic performance of laparoscopic surgeons compared to gastroenterologists and untrained individuals.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
Oliver WagnerStephan A Vorburger

Abstract

Natural orifice transluminal endoscopic surgery (NOTES) is a multidisciplinary surgical technique. If conventional endoscopic instrumentation can be easily mastered, surgeons with laparoscopic experience could head NOTES interventions. Thirty individuals were tested for endoscopic dexterity. Group 1 included seven gastroenterologists, group 2 included 12 laparoscopically experienced surgeons lacking endoscopic experience, and group 3 included 11 interns who had no hands-on endoscopic or surgical experience. Each individual repeated an easy (T1), medium (T2), and difficult (T3) task ten times with endoscopic equipment on a NOTES skills-box. Group 3 had significantly poorer performances for all three tasks compared to the other groups. No significant differences were seen between groups 1 and 2 for T1 and T2. The initial T3 performance of group 1 was better than that of group 2, but their performance after repetition was not statistically different. Groups 2 and 3 improved significantly with repetition, and group 2 eventually performed as well as group 1. The data indicate that laparoscopic surgeons quickly learned to handle the endoscopic equipment. This suggests that a lack of endoscopic experience does not handicap laparoscopi...Continue Reading

References

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Citations

Feb 4, 2011·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Emmeline NugentPaul Neary
Feb 22, 2012·Urology Annals·Wassim M BazziIthaar H Derweesh
Jan 29, 2013·Surgical Innovation·Masood R MoghulAra Darzi
Dec 15, 2010·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·J C Kalff, N Schäfer

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