Biomedical subjects

L Gellman

Publications and source records attributed to L Gellman.

3 recordsLinked to original sources

PubMed2001

Surgeon-specific factors in the acquisition of laparoscopic surgical skills.

BACKGROUND: Training and experience vary widely among surgeons performing laparoscopic surgery (LS). Visual perceptual demands are greater for LS than for traditional surgery, necessitating greater understanding of surgeon variables in skill acquisition and performance. METHODS: During an LS skills course incorporating didactic and simulator-based instruction, 94 surgeons completed an experience/demographic questionnaire, a test of course-specific knowledge acquisition, 10 trials of three dexterity drills, 15 suturing trials using course-specific methods, and 3 standardized tests of visual perception. RESULTS: Age, years posttraining, and visual perception correlated significantly with time required to complete drills and suturing trials (Pearson correlations ranged from r = 0.21, P <0.05, to r = 0.51, P <0.001) even after statistically controlling for variations in knowledge acquisition, which correlated (r = 0.30, P <0.01) with suturing speed. CONCLUSIONS: Surgeon variables play a significant role in speed of acquisition and performance of LS skills. Further studies need to elucidate their role in quality of LS performance.

Adult↗

PubMed2000

Experience and visual perception in resident acquisition of laparoscopic skills.

Assess the role of experience and visual perception (VP) in resident acquisition of laparoscopic surgical skills (LSS).Thrity-nine residents (20 PGY-1s tested just before starting residency; 19 PGY 3+) completed an LSS course, including examination of course-specific knowledge before and after didactic tutorials, 10 trials of 3 dexterity drills and suturing, and 3 standardized VP tests.Mean speed increased significantly (p < 0.001) across trials for all dexterity drills and suturing. Senior residents performed suturing trials 1 to 4 significantly faster (p < 0.05) than did PGY 1's (M +/- SD averaged across trials 1 to 4: 166.5 +/- 59.9 vs 252.3 +/- 108.2 seconds, p < 0.01). Group differences on later trials were progressively smaller and nonsignificant, as were all group differences on dexterity drills. Significant correlations between VP and speed on drills ranged from (r = -0.41, p < 0.01) to (r = -0.71, p < 0.001). Visual perception did not correlate significantly with suturing speed; neither pretest nor posttest scores correlated significantly with drill or suturing speeds.Residents at all levels can significantly increase LSS performance speed to comparable levels during a brief intensive skills course. Proficiency in specific aspects of VP is directly associated with performance speed on dexterity drills, shown in previous studies to be fundamental in the development of intracorporeal suturing skill. (Curr Surg 57:368-372. Copyright 2000 by the Association of Program Directors in Surgery.)

Journal Article↗

PubMed1996

Laparoscopic assisted colectomy.

BACKGROUND: The role and feasibility of laparoscopic assisted colectomy (LAC) in both benign and malignant disease of the colon are not clear. We have reviewed our series in an effort to further delineate whether or not LAC is appropriate in the treatment of colonic disease. METHODS: This is a retrospective view of a personal series focusing on feasibility, cure of malignant disease, and length of stay (LOS). RESULTS: One hundred and two LACs were completed out of 104 attempts (98%). There were no wound or trocar implants in the Dukes A, B and C patients. Lymph node retrieval was similar in the laparoscopic and open historical controls. The LOS was 5.9 days in the LAC group as compared with 11 days in the open group. There was a 4.8% major morbidity rate and a 1% mortality rate in this series. CONCLUSIONS: LAC is technically feasible in a high percentage of patients. While a definite statement regarding its use in malignant disease can not be ascertained from this review, the preliminary results are encouraging. A randomized trial comparing open and LAC is warranted.

Adult↗