シニアレジデントに対する腹腔鏡下結腸切除術のトレーニングプログラム

Result of senior resident training program for laparoscopic colectomy

◆要旨：当科におけるシニアレジデントに対する腹腔鏡下結腸切除術トレーニングプログラムの結果を報告する．2014年4月から2017年3月までに20名が参加した．初期1か月にカメラ助手を経験後，1日間の動物実習，残り3か月間に内視鏡外科技術認定医指導下に術者を経験した．63症例の手術がレジデントにより施行された．回盲部切除術（40例）とS状結腸切除術（23例）の手術時間（中央値）はそれぞれ190分と232分であった．51/63例（81％）で術者交代なく完遂されていた．術後，縫合不全やイレウスなどの重篤な合併症は認められなかった．シニアレジデントによる腹腔鏡下結腸切除術は本プログラム下に安全に施行されていた．

We report the outcome of training program for senior residents for laparoscopic colectomy. From April 2014 to March 2017, 20 senior residents participated in a four-month training program in our department. The residents served as camera operator for the first month, then participated in one-day animal surgery laboratory experience. For the last three months, they served as operator under the supervision of surgeons certified by the Japan Society for Endoscopic Surgery. A total of 63 patients with colon cancer underwent laparoscopic colectomy performed by the residents. Median operating time for ileocolic resection （n＝40） was 190 minutes and sigmoidectomy （n＝23） was 232 minutes. Fifty one of the 63 procedures （81％） were completed by residents. There were no conversions to open surgery. There were no major postoperative complications such as anastomotic leakage or ileus. Under this training program, laparoscopic colectomy was performed safely by the senior residents.