Aquisição de habilidade em sutura laparoscópica
Acquisition of skill in laparoscopic suture
Hamilton Cezar Rocha Garcia, Wescley Miguel Pereira da Silva, Andressa Miléo Ferraioli Silva, Brisa da Silva Lopes, Daniel Haber Feijó, Mariana Albuquerque Dórea, Luiz Claudio Lopes Chaves, Marcus Vinicius Henriques Brito
Resumo
Objetivo: Avaliar aquisição de habilidade de residentes de Cirurgia Geral em modelo de treinamento de sutura videocirúrgica. Método: Selecionaram-se randomicamente 7 preceptores com experiência comprovada na técnica videolaparoscópica (Grupo P), 7 residentes do 1° ano (Grupo R1) e 7 residentes do 2° ano (Grupo R2) dentre os serviços de residência médica em Cirurgia Geral de Belém do Pará. Todos foram submetidos a 4 sessões práticas de treinamento em sutura videolaparoscópica utilizando modelos de fibra de vidro e etil vinil acetato (E.V.A.) do Centro de Treinamento de Laparoscopia do Centro Hospitalar Jean Bitar, para aferição do tempo necessário para a realização dos 5 nós por cada indivíduo do estudo. Os dados obtidos foram analisados pelos testes Friedman e ANOVA um critério (complementado pelo teste de TUKEY). Resultados: Entre os membros do Grupo R1 houve ganho estatisticamente significante entre a 1ª e 3 ª semanas, entre a 1ª e 4ª e entre a 2ª e 4ª. Nos membros do grupo R2 houve ganho estatisticamente significante entre a 1ª e 2ª, entre a 1ª e 3ª e entre a 1ª e 4ª. Já no grupo P, houve ganho estatisticamente significante entre a 1ª e 4ª e entre a 2ª e 4ª. Na análise intergrupos, houve igualdade entre os tempos dos grupos R1 e R2 nas 4 semanas e estes obtiveram tempos maiores que o Grupo P em todas as quatro semanas com p = 0,01. Conclusão: Houve diminuição do tempo de confecção da sutura videocirúrgica, no modelo de treinamento proposto.
Palavras-chave
Abstract
Purpose: To evaluate skill acquisition of residents of General Surgery in a model of surgical suture training. Method: Seven preceptors with proven experience in videolaparoscopic technique (Group P), 7 first-year residents (Group R1) and 7 second-year residents (Group R2) were randomly selected from among the medical residency services in General Surgery of Belém/Pa. All of them underwent 4 practical sessions of videolaparoscopic suture training using fiberglass and ethyl vinyl acetate (EVA) models of the Laparoscopic Training Center of the Jean Bitar Hospital Center, in order to assess the time required to perform the 5 knots per each study subject. The data obtained were analyzed by the Friedman tests and one ANOVA criterion (complemented by the TUKEY test). Results: Among the members of the R1 group there was a statistically significant gain between the 1st and 3rd weeks, between the 1st and 4th and between the 2nd and 4th. Among the members of the R2 group there was a statistically significant gain between the 1st and 2nd, 1st and 3rd and between 1st and 4th. In group P, there was a statistically significant gain between the 1st and 4th and between the 2nd and 4th. In the intergroup analysis, there was equality between the times of the R1 and R2 groups at the 4 weeks, and these times had times greater than the Group P in all four weeks with p = 0.01. Conclusion: There was a decrease in the length of time of the laparoscopic suture, in the proposed training model.
Keywords
Referências
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