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Sohail AH, Martinez KA, Flesner SL, Martinez C, Nguyen H, Jreisat BH, Ye IB, Goyal A, Rohail A, Pacheco TBS, Williams CE, Askeri A, Levine J. Operative Experience of Esophageal Surgery among General Surgery Residents in the United States: An Analysis of ACGME Operative Case Logs. J Surg Educ 2024; 81:639-646. [PMID: 38556439 DOI: 10.1016/j.jsurg.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 01/16/2024] [Accepted: 01/25/2024] [Indexed: 04/02/2024]
Abstract
INTRODUCTION Esophageal surgery is an essential component of general surgery training and encompasses several types of cases that are logged by general surgery residents. There is a scarcity of data on the quality and volume of esophageal surgery experience during surgical residency in the United States. We analyzed trends for 9 different esophageal procedure categories logged by residents in the United States, with the aim to identify areas for improvement in training. METHODS We conducted a retrospective analysis of operative case logs of all general surgery residents graduating from programs accredited by the ACGME over a fourteen-year period from 2009 to 2023. Data on mean esophageal cases reported by graduates, including mean in each procedure subcategory were retrieved. Cases were categorized as either surgeon chief or surgeon junior for each procedure category. Mann-Kendall trend test was used to obtain tau statistics and p-value for trends in mean operative surgical volume for the total number of cases in each operative category over the study period. Trends in surgeon chief and surgeon junior cases were also investigated for each operative category. RESULTS The mean number of all esophageal procedures performed per resident during their training increased significantly from 10.5 in 2009 to 16 in 2022 (τ = 0.833, p < 0.001). This trend observed among all esophageal procedures during this 14-year study can be largely attributed to the steady increase in the number and proportion of laparoscopic esophageal antireflux procedures performed (τ = 0.950, p < 0.001). Additionally, esophagectomy procedures had a statistically significant, but modest, increase during the study period (τ = 0.505, p = 0.023), from a mean of 1 case during training in 2009 to a peak of 1.3 in 2020. Although the general trend of esophagus procedures increased during the study period, most categories (7 out of 9) either decreased or did not significantly change. Esophagogastrectomy volume decreased significantly by 30%, from 1 per resident during their training in 2009 to 0.7 in 2022 (τ = -0.510, p = 0.018), esophageal diverticulectomy procedures decreased by 50% from 0.2 to 0.1 (τ = -0.609, p = 0.009), and operations for esophageal stenosis decreased by 75% from 0.4 to 0.1 (τ = -0.734, p = 0.001). Mean number of esophageal bypasses (τ = -0.128, p = 0.584), repair of perforated esophageal disease (τ = -0.333, p = 0.156), and other major esophagus procedures (τ = 0.416, p = 0.063) did not significantly change. CONCLUSION The operative volume of esophageal surgery that general surgery residents in the United States are exposed to has significantly risen over the past 14 years, largely driven by the increase in laparoscopic antireflux procedures. However, given the recent advances and the resultant heterogeneity in both esophageal surgery, the increase in resident operative volume is still inadequate to ensure the training of safe and adept esophageal surgeons, necessitating postresidency specialized training for trainees interested in esophageal surgery.
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Affiliation(s)
- Amir Humza Sohail
- University of New Mexico School of Medicine, Albuquerque, New Mexico
| | - Kevin A Martinez
- University of New Mexico School of Medicine, Albuquerque, New Mexico.
| | - Samuel L Flesner
- University of New Mexico School of Medicine, Albuquerque, New Mexico
| | - Christian Martinez
- University of New Mexico, College of Arts and Sciences, Albuquerque, New Mexico
| | - Hoang Nguyen
- University of New Mexico School of Medicine, Albuquerque, New Mexico
| | | | - Ivan B Ye
- Department of Surgery, NYU Langone Health, Long Island School of Medicine, Mineola, NY
| | - Aman Goyal
- Department of Internal Medicine, Seth GS Medical College and KEM Hospital, Mumbai, India
| | - Amal Rohail
- Midwestern University, Chicago College of Osteopathic Medicine, Chicago, Illinois
| | - Tulio B S Pacheco
- Department of Surgery, NYU Langone Health, Long Island School of Medicine, Mineola, NY
| | | | - Aysha Askeri
- Shimoga Institute of Medical Science, Shivamogga, India
| | - Jun Levine
- Department of Surgery, NYU Langone Health, Long Island School of Medicine, Mineola, NY
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de'Angelis N, Gavriilidis P, Martínez-Pérez A, Genova P, Notarnicola M, Reitano E, Petrucciani N, Abdalla S, Memeo R, Brunetti F, Carra MC, Di Saverio S, Celentano V. Educational value of surgical videos on YouTube: quality assessment of laparoscopic appendectomy videos by senior surgeons vs. novice trainees. World J Emerg Surg 2019; 14:22. [PMID: 31086560 PMCID: PMC6507219 DOI: 10.1186/s13017-019-0241-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 04/25/2019] [Indexed: 02/06/2023] Open
Abstract
Background To prepare for surgery, surgeons often recur to surgical videos, with YouTube being reported as the preferred source. This study aimed to compare the evaluation of three surgical trainees and three senior surgeons of the 25 most viewed laparoscopic appendectomy videos listed on YouTube. Additionally, we assessed the video conformity to the published guidelines on how to report laparoscopic surgery videos (LAP-VEGaS). Methods Based on the number of visualization, the 25 most viewed videos on laparoscopic appendectomy uploaded on YouTube between 2010 and 2018 were selected. Videos were evaluated on the surgical technical performance (GOALS score), critical view of safety (CVS), and overall video quality and utility. Results Video image quality was poor for nine (36%) videos, good for nine (36%), and in high definition for seven (28%). Educational content (e.g., audio or written commentary) was rarely present. With the exception of the overall level of difficulty, poor consistency was observed for the GOALS domains between senior surgeons and trainees. Fifteen videos (60%) demonstrated a satisfactory CVS score (≥ 5). Concerning the overall video quality, agreement among senior surgeons was higher (Cronbach’s alpha 0.897) than among trainees (Cronbach’s alpha 0.731). The mean overall videos utility (Likert scale, 1 to 5) was 1.92 (SD 0.88) for senior examiners, and 3.24 (SD 1.02) for trainee examiners. The conformity to the LAP-VEGaS guidelines was weak, with a median value of 8.1% (range 5.4–18.9%). Conclusion Laparoscopic videos represent a useful and appropriate educational tool but they are not sufficiently reviewed to obtained standard quality. A global effort should be made to improve the educational value of the uploaded surgical videos, starting from the application of the nowadays-available LAP-VEGaS guidelines. Electronic supplementary material The online version of this article (10.1186/s13017-019-0241-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nicola de'Angelis
- 1Department of Digestive, Hepato-Pancreato-Biliary Surgery, and Liver Transplantation, Henri-Mondor University Hospital, AP-HP, Université Paris Est, 51, Avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - Paschalis Gavriilidis
- 2Department of General and Colorectal Surgery, Northern Lincolnshire and Goole, Diana Princess of Wales Hospital, Scartho Rd, Grimsby, DN33 2BA UK
| | - Aleix Martínez-Pérez
- 3Unit of Colorectal Surgery, Department of General and Digestive Surgery, Hospital Universitario Doctor Peset, Valencia, Spain
| | - Pietro Genova
- 1Department of Digestive, Hepato-Pancreato-Biliary Surgery, and Liver Transplantation, Henri-Mondor University Hospital, AP-HP, Université Paris Est, 51, Avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - Margherita Notarnicola
- 1Department of Digestive, Hepato-Pancreato-Biliary Surgery, and Liver Transplantation, Henri-Mondor University Hospital, AP-HP, Université Paris Est, 51, Avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - Elisa Reitano
- 1Department of Digestive, Hepato-Pancreato-Biliary Surgery, and Liver Transplantation, Henri-Mondor University Hospital, AP-HP, Université Paris Est, 51, Avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - Niccolò Petrucciani
- 1Department of Digestive, Hepato-Pancreato-Biliary Surgery, and Liver Transplantation, Henri-Mondor University Hospital, AP-HP, Université Paris Est, 51, Avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - Solafah Abdalla
- 4Department of Digestive, Hepato-Pancreato-Biliary Surgery, and Liver Transplantation, Pitié-Salpêtrière University Hospital, AP-HP, Université Pièrre et Marie Curie (UPMC) et Paris-Descartes, Paris, France
| | - Riccardo Memeo
- 5Department of General Surgery, Policlinico A. Rubino, Università di Bari, Bari, Italy
| | - Francesco Brunetti
- 1Department of Digestive, Hepato-Pancreato-Biliary Surgery, and Liver Transplantation, Henri-Mondor University Hospital, AP-HP, Université Paris Est, 51, Avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - Maria Clotilde Carra
- 6University Paris Diderot, Paris France, Rothschild Hospital, AP-HP, Paris, France
| | - Salomone Di Saverio
- 7Department of Surgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Valerio Celentano
- 8Colorectal Unit, Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth, UK
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