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

Wagner, Oliver J.; Hagen, Monika; Morel, Philippe; Inan, Ihsan; Candinas, Daniel; Vorburger, Stephan A.

doi:10.1007/s11605-008-0649-x

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Title		Who should do NOTES? Initial endoscopic performance of laparoscopic surgeons compared to gastroenterologists and untrained individuals
Authors		Wagner, Oliver J. Hagen, Monika Morel, Philippe Inan, Ihsan Candinas, Daniel Vorburger, Stephan A.
Published in		Journal of Gastrointestinal Surgery. 2008, vol. 12, no. 10, p. 1724-1729
Abstract		INTRODUCTION: 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. MATERIALS AND METHODS: 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. RESULTS: 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. CONCLUSIONS: The data indicate that laparoscopic surgeons quickly learned to handle the endoscopic equipment. This suggests that a lack of endoscopic experience does not handicap laparoscopic surgeons when performing endoscopic tasks. Based on their knowledge of anatomy and the complication management acquired during surgical education, surgeons are well equipped to take the lead in interdisciplinary NOTES collaborations.
Keywords		Adult — Clinical Competence — Education, Medical, Graduate — Endoscopy/statistics & numerical data — Female — Gastroenterology/statistics & numerical data — General Surgery/*statistics & numerical data — Humans — Internship and Residency — Male — Psychomotor Performance
Identifiers		DOI: 10.1007/s11605-008-0649-x PMID: 18726133
Full text		Article - Limited access to UNIGE Other version: http://www.springerlink.com/content/u257r608k6375110/fulltext.pdf
Structures		Faculté de médecine / Section de médecine clinique / Département de chirurgie
Research group		Chirurgie viscérale (104)
Citation (ISO format)		WAGNER, Oliver J. et al. Who should do NOTES? Initial endoscopic performance of laparoscopic surgeons compared to gastroenterologists and untrained individuals. In: Journal of Gastrointestinal Surgery, 2008, vol. 12, n° 10, p. 1724-1729. doi: 10.1007/s11605-008-0649-x https://archive-ouverte.unige.ch/unige:19142