Skip to main content

Entwicklung im Experiment und Ausbildung für die klinische Anwendung

  • Chapter
Endoskopische Wirbelsäulenchirurgie
  • 29 Accesses

Zusammenfassung

Die rasche Einführung laparoskopischer Techniken in die tägliche Routine der klinischen Chirurgie hat den praktizierenden Chirurgen gezwungen, sich in überaus kurzer Zeit mit neuen Operationstechniken auseinanderzusetzen. Standardisierte Methoden zur Entwicklung der neuen minimal-invasiven Techniken sowie ein reglementiertes Ausbildungs- und Trainingsprogramm standen jedoch nicht immer zur Verfügung. Entsprechend zeigen klinische Untersuchungen bei verschiedenen, insbesondere bei komplexen laparoskopischen Eingriffen eine protrahierte Lernkurve [1–3]. Während für die laparoskopische Lymphadenektomie sowie für die Cholezystektomie 30 Eingriffe zur Überwindung der Lernkurve postuliert wurden [4, 5], so mögen für komplexere Interventionen, wie Fundoplicatio, Hernioraphie und Kolektomie, deutlich mehr Eingriffe erforderlich sein [3, 6–8].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 44.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 59.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Similar content being viewed by others

Literatur

  1. Richardson M.C., Bell G, Fullarton G.M. (1996) Incidence and nature of bile duct injuries following laparoscopic cholecystectomy: an audit of 5913 cases. West of Scotland Laparoscopic Cholecystectomy Audit Group. Br J Surg 83:1356–1360

    Article  PubMed  CAS  Google Scholar 

  2. Bennett C.L., Stryker S.J., Ferreira M.R., Adams J, Beart R.W. Jr (1997) The learning curve for laparoscopic colorectal surgery. Preliminary results from a prospective analysis of 1194 laparoscopic-assisted colectomies. Arch Surg 132:41–44

    Article  PubMed  CAS  Google Scholar 

  3. Leibl B.J., Schmedt C.G., Schwarz I, Daubler P, Kraft K, Schlossnickel B, Bittner R (1998) A single institution’s experience with transperitoneal laparoscopic hernia repair. Am J Surg 175:446–451

    Article  PubMed  CAS  Google Scholar 

  4. Guazzoni G, Montorsi F, Bergamaschi F, Bellinzoni P, Centemero A, Consonni P, Rigatti P (1994) Open surgical revision of laparoscopic pelvic lymphadenectomy for staging of prostate cancer: the impact of laparoscopic learning curve. J Urol 151:930–933

    PubMed  CAS  Google Scholar 

  5. Moore M.J., Bennett C.L. (1995) The learning curve for laparoscopic cholecystectomy. The Southern Surgeons Club. Am J Surg 170:55–59

    Article  PubMed  CAS  Google Scholar 

  6. Harris S.C. (1996) Laparoscopic antireflux surgery. Am J Surg 171: 482–484

    Article  PubMed  CAS  Google Scholar 

  7. Soot S.J., Eshraghi N, Farahmand M, Sheppard B.C., Deveney C.W. (1999) Transition from open to laparoscopic fundoplication: the learning curve. Arch Surg 134:278–281

    Article  PubMed  CAS  Google Scholar 

  8. Wishner J.D., Baker J.W. Jr, Hoffman G.C., Hubbard G.W. 2nd, Gould R.J., Wohlgemuth S.D., Ruffin W.K., Melick C.F. (1995) Laparoscopic-assisted colectomy. The learning curve. Surg Endosc 9:1179–1183

    Article  PubMed  CAS  Google Scholar 

  9. See W.A., Cooper C.S., Fisher R.J. (1993) Predictors of laparoscopic complications after formal training in laparoscopic surgery. JAMA 270:2689–2692

    Article  PubMed  CAS  Google Scholar 

  10. Watson D.I., Baigrie R.J., Jamieson G.G. (1996) A learning curve for laparoscopic fundoplication. Definable, avoidable, or a waste of time? Ann Surg 224:198–203

    Article  PubMed  CAS  Google Scholar 

  11. Gates E.A. (1997) New surgical procedures: can our patients benefit while we learn? Am J Obstet Gynecol 176:1293–1298

    Article  PubMed  CAS  Google Scholar 

  12. Stoker M.E., Patwardhan N, Maini B.S. (1995) Laparoscopic adrenal surgery. Surg Endosc 9:387–390

    Article  PubMed  CAS  Google Scholar 

  13. Deans G.T., Kappadia R, Wedgewood K, Royston C.M., Brough W.A. (1995) Laparoscopic adrenalectomy. Br J Surg 82:994–995

    Article  PubMed  CAS  Google Scholar 

  14. Clayman R.V., Kavoussi L.R., McDougall E.M., Soper N.J., Figenshau R.S., Chandhoke P.S., Albala D.M. (1992) Laparoscopic nephrectomy: a review of 16 cases. Surg Laparosc Endosc 2:29–34

    PubMed  CAS  Google Scholar 

  15. Kerbl K, Figenshau R.S., Clayman R.V., Chandhoke P.S., Kavoussi L.R., Albala D.M., Stone A.M. (1993) Retroperitoneal laparoscopic nephrectomy: laboratory and clinical experience. J Endourol 7:23–26

    Article  PubMed  CAS  Google Scholar 

  16. Ratner L.E., Ciseck L.J., Moore R.G., Cigarroa F.G., Kaufman H.S., Kavoussi L.R. (1995) Laparoscopic live donor nephrectomy. Transplantation 60:1047–1049

    PubMed  CAS  Google Scholar 

  17. Flowers J.L., Jacobs S, Cho E, Morton A, Rosenberger W.F., Evans D, Imbembo A.L., Bartlett S.T. (1997) Comparison of open and laparoscopic live donor nephrectomy. Ann Surg 226:483–489

    Article  PubMed  CAS  Google Scholar 

  18. Hertlein H, Hartl W.H., Dienemann H, Schurmann M, Lob G (1995) Thoracoscopic repair of thoracic spine trauma. Eur Spine J 4:302–307

    Article  PubMed  CAS  Google Scholar 

  19. Bühren V, Beisse R, Potulski M (1997) Minimally invasive ventral spondylodesis in injuries to the thoracic and lumb ar spine. Chirurg 68:1076–1084

    Article  PubMed  Google Scholar 

  20. Zucherman J.F., Zdeblick T.A., Bailey S.A., Mahvi D, Hsu K.Y., Kohrs D (1995) Instrumented laparoscopic spinal fusion. Preliminary Results. Spine 20:2029–2034

    Article  PubMed  CAS  Google Scholar 

  21. Olinger A, Hildebrandt U, Pistorius G, Lindemann W, Menger M.D. (1996) Laparoscopic 2-level fusion of the lumb ar spine with Bagby and Kuslich implants. Chirurg 67:348–350

    PubMed  CAS  Google Scholar 

  22. Olsen D, McCord D, Law M (1996) Laparoscopic discectomy with anterior interbody fusion of L5-S1. Surg Endosc 10:1158–1163

    Article  PubMed  CAS  Google Scholar 

  23. Hildebrandt U, Pistorius G, Olinger A, Menger M.D. (1996) First experience with laparoscopic spine fusion in an experimental model in the pig. Surg Endosc 10:143–146

    Article  PubMed  CAS  Google Scholar 

  24. Southerland S.R., Remedios A.M., McKerrell J.G., Litwin D (1995) Laparoscopic approaches to the lumbar vertebrae. An anatomic study using a porcine model. Spine 20:1620–1623

    Article  PubMed  CAS  Google Scholar 

  25. Olinger A, Hildebrandt U, Vollmar B, Feifel G, Mutschier W, Menger M.D. (1999) Laparoscopic-transperitoneal and lumboscopic-retroperitoneal surgery of the spine. Developments from animal experiments for use in clinical practice. Zentralbl Chir 124:311–317

    PubMed  CAS  Google Scholar 

  26. Olinger A, Hildebrandt U, Mutschier W, Menger M.D. (1999) First clinical experience with an endoscopic retroperitoneal approach for anterior fusion of lumbar spine fractures from levels T12 to L5. Surg Endosc 13:1215–1219

    Article  PubMed  CAS  Google Scholar 

  27. Vollmar B, Olinger A, Hildebrandt U, Menger M.D. (in press) Reliable non-invasive parameters for early detection of CO2-thoraco-retroperitoneum-induced cardiopulmonary dysfunction in minimally invasive thoraco-lumboendoscopic spine surgery. Surg Endosc

    Google Scholar 

  28. Vollmar B, Olinger A, Hildebrandt U, Menger M.D. (1999) Cardiopulmonary dysfunction during minimally-invasive thoraco-lumboendoscopic spine surgery. Anesth Analg 88:1244–1251

    PubMed  CAS  Google Scholar 

  29. Chung J.Y., Sackier J.M. (1998) A method of objectively evaluating improvements in laparoscopic skills. Surg Endosc 12:1111–1116

    Article  PubMed  CAS  Google Scholar 

  30. Schwaitzberg S.D., Connolly R.J., Sant G.R., Reindollar R, Cleveland R.J. (1996) Planning, development, and execution of an international training program in laparoscopic surgery. Surg Laparosc Endosc 6:10–15

    Article  PubMed  CAS  Google Scholar 

  31. Shapiro S.J., Gordon L.A., Daykhovsky L, Senter N (1994) The laparoscopic hernia trainer. The role of a life-like trainer in laparoendoscopic education. Endosc Surg Allied Technol 2:66–68

    PubMed  CAS  Google Scholar 

  32. Sackier J.M., Berci G, Paz-Partlow M (1991) A new training device for laparoscopic cholecystectomy. Surg Endosc 5:158–159

    Article  PubMed  CAS  Google Scholar 

  33. Henkel T.O., Potempa D.M., Rassweiler J, Manegold B.C., Alken P (1993) Lap simulator, animal studies, and the Laptent. Bridging the gap between open and laparoscopic surgery. Surg Endosc 7:539–543

    Article  PubMed  CAS  Google Scholar 

  34. Wolfe B.M., Szabo Z, Moran M.E., Chan P, Hunter J.G. (1993) Training for minimally invasive surgery. Need for surgical skills. Surg Endosc 7:93–95

    Article  PubMed  CAS  Google Scholar 

  35. Clerici T, Lange I, Zerz A, Beller S, Szinicz G, Losert U.O., Siegl H, Fugger R (1995) Educational opportunities in minimally invasive surgery. Wien Klin Wochenschr 107:43–48

    PubMed  CAS  Google Scholar 

  36. Kopchok G.E., Cavaye D.M., Klein S.R., Mueller M.P., Lee J.L., White R.A. (1993) Endoscopic surgery training: application of an in vitro trainer and in vivo swine model. J Invest Surg 6:329–337

    Article  PubMed  CAS  Google Scholar 

  37. Watson D.I., Treacy P.J., Williams J.A. (1995) Developing a training model for laparoscopic common bile duct surgery. Surg Endosc 9: 1116–1118

    PubMed  CAS  Google Scholar 

  38. Srinivasan A, Trus T.L., Conrad A.J., Scarbrough T.J. (1999) Common laparoscopic procedures in swine: a review. J Invest Surg 12:5–14

    Article  PubMed  CAS  Google Scholar 

  39. Schob O.M., Day P.W., Josloff R.K., Zucker K.A. (1996) An experimental teaching model for laparoscopic choledochojejunostomy. Surg Laparosc Endosc 6:341–347

    Article  PubMed  CAS  Google Scholar 

  40. Böhm B, Milsom J.W. (1994) Animal models as educational tools in laparoscopic colorectal surgery. Surg Endosc 8:707–713

    Article  PubMed  Google Scholar 

  41. Garcia-Ruiz A, Naitoh T, Gagner M (1998) A porcine model for laparoscopic ventral hernia repair. Surg Laparosc Endosc 8:35–39

    Article  PubMed  CAS  Google Scholar 

  42. Henkel T.O., Potempa D.M., Rassweiler J, Frede T, Stock C, Alken P (1994) Experimental studies for clinical standardization of trans abdominal laparoscopic nephrectomy. Eur Urol 25:55–61

    PubMed  CAS  Google Scholar 

  43. Jones D.B., Thompson R.W., Soper N.J., Olin J.M., Rubin B.G. (1996) Development and comparison of transperitoneal and retroperitoneal approaches to laparoscopic-assisted aortofemoral bypass in a porcine model. J Vasc Surg 23:466–471

    Article  PubMed  CAS  Google Scholar 

  44. Klotz H.P., Gresser J, Weder W (1995) Thoracoscopic surgery-experiences with a practical training course using an animal models. Chirurg 66:519–521

    PubMed  CAS  Google Scholar 

  45. Olinger A, Pistorius G, Lindemann W, Vollmar B, Hildebrandt U, Menger M.D. (1999) Effectiveness of a hands-on training course for laparoscopic spine surgery in a porcine model. Surg Endosc 13:118–122

    Article  PubMed  CAS  Google Scholar 

  46. Shapiro S.J., Paz-Partlow M, Daykhovsky L, Gordon L.A. (1996) The use of a modular skills center for the maintenance of laparoscopic skills. Surg Endosc 10:816–819

    Article  PubMed  CAS  Google Scholar 

  47. Morino M, Festa V, Garrone C (1995) Survey on Torino courses. The impact of a two-day practical course on apprenticeship and diffusion of laparoscopic cholecystectomy in Italy. Surg Endosc 9:46–48

    Article  PubMed  CAS  Google Scholar 

  48. Rosser J.C. Jr, Rosser L.E., Savalgi R.S. (1998) Objective evaluation of a laparoscopic surgical skill program for residents and senior surgeons. Arch Surg 133:657–661

    Article  PubMed  Google Scholar 

  49. Hanna G.B., Frank T.G., Cuschieri A (1997) Objective assessment of endoscopic knot quality. Am J Surg 174:410–413

    Article  PubMed  CAS  Google Scholar 

  50. Mori T, Hatano N, Maruyama S, Atomi Y (1998) Significance of “hands-on training” in laparoscopic surgery. Surg Endosc 12:256–260

    Article  PubMed  CAS  Google Scholar 

  51. Melvin W.S., Johnson J.A., Ellison E.C. (1996) Laparoscopic skills enhancement. Am J Surg 172:377–379

    Article  PubMed  CAS  Google Scholar 

  52. Rosser J.C., Rosser L.E., Savalgi R.S. (1997) Skill acquisition and assessment for laparoscopic surgery. Arch Surg 132:200–204

    Article  PubMed  CAS  Google Scholar 

  53. Derossis A.M., Fried G.M., Abrahamowicz M, Sigman H.H., Barkun J.S., Meakins J.L. (1998) Development of a model for training and evaluation of laparoscopic skills. Am J Surg 175:482–487

    Article  PubMed  CAS  Google Scholar 

  54. See W.A., Cooper C.S., Fisher R.J. (1993) Predictors of laparoscopic complications after formal training in laparoscopic surgery. JAMA 270:2689–2692

    Article  PubMed  CAS  Google Scholar 

  55. Wilson M.S., Middlebrook A, Sutton C, Stone R, McCloy R.F. (1997) MIST VR: a virtual reality trainer for laparoscopic surgery assesses performance. Ann R Coll Surg Engl 79:403–404

    PubMed  CAS  Google Scholar 

  56. Downes M, Cavusoglu M.C., Gantert W, Way L.W., Tendick F (1998) Virtual environments for training critical skills in laparoscopic surgery. Stud Health Technol Inform 50:316–322

    PubMed  CAS  Google Scholar 

  57. Gallagher A.G., McClure N, McGuigan J, Crothers I, Browning J (1999) Virtual reality training in laparoscopic surgery: a preliminary assessment of minimally invasive surgical trainer virtual reality (MIST VR). Endoscopy 31:310–313

    Article  PubMed  CAS  Google Scholar 

  58. Taffinder N, Sutton C, Fishwick R.I., McManus I.C., Darzi A (1998) Validation of virtual reality to teach and assess psychomotor skills in laparoscopic surgery: results from randomised controlled studies using the MIST VR laparoscopic simulator. Stud Health Technol Inform 50:124–130

    PubMed  CAS  Google Scholar 

Download references

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 2000 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Menger, M.D., Vollmar, B. (2000). Entwicklung im Experiment und Ausbildung für die klinische Anwendung. In: Endoskopische Wirbelsäulenchirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-57118-3_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-57118-3_2

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-63058-3

  • Online ISBN: 978-3-642-57118-3

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics