From FUSE to a hands-on electrosurgery course using a cadaveric model.
Curriculum
Electrosurgery
Energy device
FUSE
Patient safety
Surgical education
Journal
Surgical endoscopy
ISSN: 1432-2218
Titre abrégé: Surg Endosc
Pays: Germany
ID NLM: 8806653
Informations de publication
Date de publication:
11 Jul 2024
11 Jul 2024
Historique:
received:
17
04
2024
accepted:
30
06
2024
medline:
12
7
2024
pubmed:
12
7
2024
entrez:
11
7
2024
Statut:
aheadofprint
Résumé
Surgical procedures in contemporary practice frequently employ energy-based devices, yet comprehensive education surrounding their safety and effectiveness remains deficient. We propose an innovative course for residents that aims to provide basic electrosurgery knowledge and promote the safe use of these devices. We developed a simulated training course for first-year general surgery and orthopedic residents. First, a survey was conducted regarding their knowledge perception about energy devices. The course consisted of two online theoretical sessions, followed by three in-person practical sessions. First-year residents performed three video-recorded attempts using a cadaveric model and were assessed through a digital platform using the Objective Structured Assessment of Technical Skill (OSATS), a Specific Rating Scale (SRS), and a surgical energy-based devices scale (SEBS). Third-year residents were recruited as a control group. The study included 20 first-year residents and 5 third-year residents. First-year residents perceived a knowledge gap regarding energy devices. Regarding practical performance, both OSATS and checklist scores were statistically different between novices at their first attempt and the control group. When we analyzed the novice's performance, we found a significant increase in OSATS (13 vs 21), SRS (13 vs 17.5), and SEBS (5 vs 7) pre- and post-training scores. The amount of feedback referred to skin burns with the electro-scalpel reduced from 18 feedbacks in the first attempt to 2 in the third attempt (p-value = 0.0002). When comparing the final session of novices with the control group, no differences were found in the SRS (p = 0.22) or SEBS (p = 0.97), but differences remained in OSATS (p = 0.017). This study supports the implementation of structured education in electrosurgery among surgical trainees. By teaching first-year residents about electrosurgery, they can acquire a skill set equivalent to that of third-year residents. The integration of such courses can mitigate complications associated with energy device misuse, ultimately enhancing patient safety.
Identifiants
pubmed: 38992283
doi: 10.1007/s00464-024-11033-0
pii: 10.1007/s00464-024-11033-0
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Références
Feldman LS, Fuchshuber P, Jones DB, Mischna J, Schwaitzberg SD (2012) Surgeons don’t know what they don’t know about the safe use of energy in surgery. Surg Endosc 26:2735–2739. https://doi.org/10.1007/s00464-012-2263-y
doi: 10.1007/s00464-012-2263-y
pubmed: 22538677
ECRI Institute (2020) Health devices: top 10 health technology hazards for 2020.Available at https://www.ecri.org/landing-2020-top-ten-health-technology-hazards/ January 10, 2024.
Nduka CC, Super PA, Monson JR, Darzi AW (1994) Cause and prevention of electrosurgical injuries in laparoscopy. J Am Coll Surg 179:161–170
pubmed: 8044385
Malik AA, Khan RS, Khan RN, Shakeel O, Ahmed HH, Rahid U, Fatima A, Afzal MF, Khattak S, Syed AA (2020) Lack of awareness among surgeons regarding safe use of electrosurgery. A cross sectional survey of surgeons in Pakistan. Ann Med Surg 50:24–27. https://doi.org/10.1016/j.amsu.2019.11.017
doi: 10.1016/j.amsu.2019.11.017
Ha A, Richards C, Criman E, Piaggione J, Yheulon C, Lim R (2018) The safe use of surgical energy devices by surgeons may be overestimated. Surg Endosc 32:3861–3867. https://doi.org/10.1007/s00464-018-6116-1
doi: 10.1007/s00464-018-6116-1
pubmed: 29497829
Watanabe Y, Kurashima Y, Madani A, Feldman LS, Ishida M, Oshita A, Naitoh T, Noma K, Yasumasa K, Nagata H, Nakamura F, Ono K, Suzuki Y, Matsuhashi N, Shichinohe T, Hirano S (2016) Surgeons have knowledge gaps in the safe use of energy devices: a multicenter cross-sectional study. Surg Endosc 30:588–592. https://doi.org/10.1007/s00464-015-4243-5
doi: 10.1007/s00464-015-4243-5
pubmed: 26017912
Fuchshuber P, Schwaitzberg S, Jones D, Jones SB, Feldman L, Munro M, Robinson T, Purcell-Jackson G, Mikami D, Madani A, Brunt M, Dunkin B, Gugliemi C, Groah L, Lim R, Mischna J, Voyles CR (2018) The SAGES Fundamental Use of Surgical Energy program (FUSE): history, development, and purpose. Surg Endosc 32:2583–2602. https://doi.org/10.1007/s00464-017-5933-y
doi: 10.1007/s00464-017-5933-y
pubmed: 29218661
Madani A, Watanabe Y, Vassiliou MC, Fuchshuber P, Jones DB, Schwaitzberg SD, Fried GM, Feldman LS (2014) Impact of a hands-on component on learning in the Fundamental Use of Surgical Energy™ (FUSE) curriculum: a randomized-controlled trial in surgical trainees. Surg Endosc 28:2772–2782. https://doi.org/10.1007/s00464-014-3544-4
doi: 10.1007/s00464-014-3544-4
pubmed: 24789134
Klingensmith ME, Brunt LM (2010) Focused surgical skills training for senior medical students and interns. Surg Clin North Am 90:505–518. https://doi.org/10.1016/j.suc.2010.02.004
doi: 10.1016/j.suc.2010.02.004
pubmed: 20497823
Ponton-Carss AC, Donnon T, Kortbeek JB (2014) Two for one: surgical skills and CanMEDS Roles—A combined course for surgical residents. J Surg Educ 71:419–425. https://doi.org/10.1016/j.jsurg.2013.09.006
doi: 10.1016/j.jsurg.2013.09.006
pubmed: 24797860
Belmar F, Gaete MI, Durán V, Chelebifski S, Jarry C, Ortiz C, Escalona G, Villagrán I, Alseidi A, Zamorano E, Pimentel F, Crovari F, Varas J (2023) Taking advantage of asynchronous digital feedback: development of an at-home basic suture skills training program for undergraduate medical students that facilitates skills retention. Glob Surg Educ - J Assoc Surg Educ 2:32. https://doi.org/10.1007/s44186-023-00112-w
doi: 10.1007/s44186-023-00112-w
Feldman L, Fuchshuber P, Jones DB (2012) The SAGES Manual on the Fundamental Use of Surgical Energy (FUSE). Springer New York, New York, NY
doi: 10.1007/978-1-4614-2074-3
Martin JA, Regehr G, Reznick R, Macrae H, Murnaghan J, Hutchison C, Brown M (1997) Objective structured assessment of technical skill (OSATS) for surgical residents. Br J Surg 84:273–278. https://doi.org/10.1002/bjs.1800840237
doi: 10.1002/bjs.1800840237
pubmed: 9052454
Madani A, Jones DB, Fuchshuber P, Robinson TN, Feldman LS (2014) Fundamental Use of Surgical Energy™ (FUSE): a curriculum on surgical energy-based devices. Surg Endosc 28:2509–2512. https://doi.org/10.1007/s00464-014-3623-6
doi: 10.1007/s00464-014-3623-6
pubmed: 24939162
Aigner N, Fialka C, Fritz A, Wruhs O, Zöch G (1997) Complications in the use of diathermy. Burns 23:256–264. https://doi.org/10.1016/S0305-4179(96)00113-1
doi: 10.1016/S0305-4179(96)00113-1
pubmed: 9232288
Govekar HR, Robinson TN, Varosy PD, Girard G, Montero PN, Dunn CL, Jones EL, Stiegmann GV (2012) Effect of monopolar radiofrequency energy on pacemaker function. Surg Endosc 26:2784–2788. https://doi.org/10.1007/s00464-012-2279-3
doi: 10.1007/s00464-012-2279-3
pubmed: 22538687
Robinson TN, Varosy PD, Guillaume G, Dunning JE, Townsend NT, Jones EL, Paniccia A, Stiegmann GV, Weyer C, Rozner MA (2014) Effect of radiofrequency energy emitted from monopolar “Bovie” instruments on cardiac implantable electronic devices. J Am Coll Surg 219:399–406. https://doi.org/10.1016/j.jamcollsurg.2014.03.060
doi: 10.1016/j.jamcollsurg.2014.03.060
pubmed: 25087940
Sankaranarayanan G, Resapu RR, Jones DB, Schwaitzberg S, De S (2013) Common uses and cited complications of energy in surgery. Surg Endosc 27:3056–3072. https://doi.org/10.1007/s00464-013-2823-9
doi: 10.1007/s00464-013-2823-9
pubmed: 23609857
pmcid: 3755039
Polychronidis A, Tsaroucha A, Karayiannakis A, Perente S, Efstathiou E, Simopoulos C (2005) Delayed perforation of the large bowel due to thermal injury during laparoscopic cholecystectomy. J Int Med Res 33:360–363. https://doi.org/10.1177/147323000503300312
doi: 10.1177/147323000503300312
pubmed: 15938598
Issenberg SB (1999) Simulation technology for health care professional skills training and assessment. JAMA 282:861. https://doi.org/10.1001/jama.282.9.861
doi: 10.1001/jama.282.9.861
pubmed: 10478693
Issenberg SB, McGaghie WC, Gordon DL, Symes S, Petrusa ER, Hart IR, Harden RM (2002) Effectiveness of a cardiology review course for internal medicine residents using simulation technology and deliberate practice. Teach Learn Med 14:223–228. https://doi.org/10.1207/S15328015TLM1404_4
doi: 10.1207/S15328015TLM1404_4
pubmed: 12395483
Schlick CJR, Bilimoria KY, Stulberg JJ (2020) Video-based feedback for the improvement of surgical technique: a platform for remote review and improvement of surgical technique. JAMA Surg 155:1078. https://doi.org/10.1001/jamasurg.2020.3286
doi: 10.1001/jamasurg.2020.3286
pubmed: 32902619
Tejos R, Crovari F, Achurra P, Avila R, Inzunza M, Jarry C, Martinez J, Riquelme A, Alseidi A, Varas J (2021) Video-based guided simulation without peer or expert feedback is not enough: a randomized controlled trial of simulation-based training for medical students. World J Surg 45:57–65. https://doi.org/10.1007/s00268-020-05766-x
doi: 10.1007/s00268-020-05766-x
pubmed: 32892271
Rammell J, Matthan J, Gray M, Bookless LR, Nesbitt CI, Rodham P, Moss J, Stansby G, Phillips AW (2018) Asynchronous unsupervised video-enhanced feedback as effective as direct expert feedback in the long-term retention of practical clinical skills: randomised trial comparing 2 feedback methods in a cohort of novice medical students. J Surg Educ 75:1463–1470. https://doi.org/10.1016/j.jsurg.2018.03.013
doi: 10.1016/j.jsurg.2018.03.013
pubmed: 29748142
Carey JN, Minneti M, Leland HA, Demetriades D, Talving P (2015) Perfused fresh cadavers: method for application to surgical simulation. Am J Surg 210:179–187. https://doi.org/10.1016/j.amjsurg.2014.10.027
doi: 10.1016/j.amjsurg.2014.10.027
pubmed: 25890815
Kovacs G, Levitan R, Sandeski R (2018) Clinical cadavers as a simulation resource for procedural learning. AEM Educ Train 2:239–247. https://doi.org/10.1002/aet2.10103
doi: 10.1002/aet2.10103
pubmed: 30051097
pmcid: 6050063
Reznick RK, MacRae H (2006) Teaching surgical skills — changes in the wind. N Engl J Med 355:2664–2669. https://doi.org/10.1056/NEJMra054785
doi: 10.1056/NEJMra054785
pubmed: 17182991
Searle S, Guerra C, Varas J, Achurra P, Jarry C, Navia A, Tejos R, Inzunza M, Pozo P (2020) Entrenamiento de colgajos locales en un modelo simulado de alta fidelidad y bajo costo. Rev Latinoam Simul Clínica 2:92–97. https://doi.org/10.35366/97899
doi: 10.35366/97899
Dorozhkin D, Olasky J, Jones DB, Schwaitzberg SD, Jones SB, Cao CGL, Molina M, Henriques S, Wang J, Flinn J, De S (2017) SAGES FUSE Committee. OR fire virtual training simulator: design and face validity. Surg Endosc 31(9):3527–3533. https://doi.org/10.1007/s00464-016-5379-7
doi: 10.1007/s00464-016-5379-7
pubmed: 28039649
Sankaranarayanan G, Wooley L, Hogg D, Dorozhkin D, Olasky J, Chauhan S, Fleshman JW, De S, Scott D, Jones DB (2018) Immersive virtual reality-based training improves response in a simulated operating room fire scenario. Surg Endosc 32(8):3439–3449. https://doi.org/10.1007/s00464-018-6063-x
doi: 10.1007/s00464-018-6063-x
pubmed: 29372313
Dombek M, Lopez CA, Han Z, Lungarini A, Santos N, Schwaitzberg S, Cao C, Jones DB, De S, Olasky J (2018) FUSE certification enhances performance on a virtual computer based simulator for dispersive electrode placement. Surg Endosc 32(8):3640–3645. https://doi.org/10.1007/s00464-018-6095-2
doi: 10.1007/s00464-018-6095-2
pubmed: 29442242
pmcid: 6041142