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Viggo B Kristiansen

Publications and source records attributed to Viggo B Kristiansen.

13 recordsLinked to original sources
PubMed2006

An evidence-based virtual reality training program for novice laparoscopic surgeons.

OBJECTIVE: To develop an evidence-based virtual reality laparoscopic training curriculum for novice laparoscopic surgeons to achieve a proficient level of skill prior to participating in live cases. SUMMARY BACKGROUND DATA: Technical skills for laparoscopic surgery must be acquired within a competency-based curriculum that begins in the surgical skills laboratory. Implementation of this program necessitates the definition of the validity, learning curves and proficiency criteria on the training tool. METHODS: The study recruited 40 surgeons, classified into experienced (performed >100 laparoscopic cholecystectomies) or novice groups (<10 laparoscopic cholecystectomies). Ten novices and 10 experienced surgeons were tested on basic tasks, and 11 novices and 9 experienced surgeons on a procedural module for dissection of Calot triangle. Performance of the 2 groups was assessed using time, error, and economy of movement parameters. RESULTS: All basic tasks demonstrated construct validity (Mann-Whitney U test, P < 0.05), and learning curves for novices plateaued at a median of 7 repetitions (Friedman's test, P < 0.05). Expert surgeons demonstrated a learning rate at a median of 2 repetitions (P < 0.05). Performance on the dissection module demonstrated significant differences between experts and novices (P < 0.002); learning curves for novice subjects plateaued at the fourth repetition (P < 0.05). Expert benchmark criteria were defined for validated parameters on each task. CONCLUSION: A competency-based training curriculum for novice laparoscopic surgeons has been defined. This can serve to ensure that junior trainees have acquired prerequisite levels of skill prior to entering the operating room, and put them directly into practice.

Benchmarking↗
PubMed2005

[The Danish Cholecystectomy Database--DCD].

A Danish national database has been designed to monitor the quality of cholecystectomies. Data on each operation, surgeon, patient, length of hospital stay and complications are registered prospectively. Hospital departments will periodically be informed of their own and national results and will have continuous access to their own data for further analyses. A report on the nationwide data will be published and debated once a year after a thorough expert evaluation of the results in relation to defined risk factors. The database can be the basis for future clinical development and scientific investigations.

Cholecystectomy↗
PubMed2005

[Treatment of gallstone pancreatitis in Denmark].

INTRODUCTION: The aim of the study was to describe the treatment of gallstone pancreatitis in Denmark and to compare it to the recommendations given in the National Reference Programme for the treatment of patients with gallstone disease. MATERIALS AND METHODS: A questionnaire was sent to the 42 general surgical hospital departments in Denmark. RESULTS: All of the departments returned the questionnaire. All of them treated patients with gallstone pancreatitis; 40 of them performed laparoscopic cholecystectomy. The severity of gallstone pancreatitis was estimated in 29 departments. In patients with mild gallstone pancreatitis, 6 departments used ERCP in the evaluation of choledocholithiasis. In patients with mild gallstone pancreatitis who did not undergo an ERCP procedure with sphincterotomy, 13 departments performed laparoscopic cholecystectomy during the same admission after an acute attack. DISCUSSION: In agreement with the recommendations given in the National Reference Programme, the majority of Danish surgical departments used laparoscopic cholecystectomy in the treatment of patients with gallstone pancreatitis who had not undergone ERCP with sphincterotomy. To avoid the high recurrence of gallstone pancreatitis, laparoscopic cholecystectomy during the same admission is recommended. This recommendation was, however, followed by less than half of the surgical departments.

Acute Disease↗
PubMed2005

[Effect of laparoscopic cholecystectomy on the quality of life of patients with uncomplicated socially disabling gallstone disease].

INTRODUCTION: The indication for cholecystectomy in symptomatic, uncomplicated gallstone disease varies in the literature, and there is no international consensus. In Denmark, laparoscopic cholecystectomy is recommended for patients with uncomplicated cholecystolithiasis and socially disabling pain. Postoperative health-related quality of life on this indication is unknown. MATERIALS AND METHODS: A prospective consecutive study was conducted. Patients with uncomplicated cholecystolithiasis and socially disabling pain were included and underwent laparoscopic cholecystectomy in the department of day surgery. All patients had uncomplicated gallstone disease. An internationally validated questionnaire, the Gastrointestinal Quality of Life Index (GIQLI), was completed one week before and six weeks after the operation. The questionnaire comprises 32 questions covering five items related to gastrointestinal disease, and each question is rated on a scale of 0 to 4 points. The maximum GIQLI score (GIQLI total) is 128 points (32 x 4 points) and represents the best possible health-related quality of life. RESULTS: 75 consecutive patients (62 women) underwent uneventful operations. All patients returned the pre- and postoperative questionnaire. The median age was 42 years (range 18-69), the median body mass index was 26 (19-39) and the median operation time was 56 minutes (24-130). The median GIQLI total scores were 99 (33-127) and 112 (82-128) before and after operation, respectively (P < 0.001). Scores on all five sub-items were significantly improved as well. CONCLUSION: Laparoscopic cholecystectomy improves the health-related quality of life six weeks after the operation in patients with socially disabling, uncomplicated cholecystolithiasis.

Adult↗
PubMed2003

[Organization of the preoperative patient's course in ambulatory laparoscopic cholecystectomy].

INTRODUCTION: The aim was to describe the organisation of an out-patient clinic for patients with gallstone disease in a day-surgery department and to evaluate the collaboration between admitting doctors and the hospital concerning the preoperative course. MATERIAL AND METHODS: 101 patients who had gallstone disease were admitted consecutively to the out-patient clinic. Information provided by the admitting doctors regarding the history of the disease, the blood-samples and the ultrasound was registered. Information of the treatment was subsequently obtained from medical records. RESULTS: On the admission 15% had symptoms, in 28% there were results of the liver function-test and in 56% there were results of ultrasound on the liver, gallbladder and pancreas. 46 patients were direct scheduled for surgery without further investigation and eight patients were finished without any treatment. In total 65 patients were operated, 23 patients were finished without any treatment, five patients were further elucidated and in eight cases no decision were taken concerning treatment by the end of the study. DISCUSSION: It was possible to schedule surgery at the first consultation in only 50% of the patients admitted with gallstone disease. The reason was mostly missing information from the liver function test or the ultrasound examination of the liver and bile ducts. Collaboration between the general practitioners and the hospital is of importance to achieve a rational preoperative evaluation of patients admitted with gallstone disease.

Adult↗
PubMed2003

[Treatment of gastroduodenal obstruction with self-expanding stent].

Self-expanding metal stents are used in some centres as non-surgical palliation for malignant gastric outlet obstruction as an alternative to surgery. No randomized studies exist comparing these two treatment modalities. Descriptive series have shown high success rates of 82-100% for stent placement, and 75-100% of the patients experience relief of the vomiting and ability to eat semisolid to solid food. Reobstruction was seen in about 15% of the patients requiring a second stenting. Serious complications to the stenting procedure have been reported in case studies. It is recommended to perform randomized studies of stenting versus open and laparoscopic surgical bypass for malignant gastric outlet obstruction.

Anastomosis, Surgical↗
PubMed2003

[Ventral herniotomy. Development of surgical technique and effect on the frequency of recurrence].

The surgical journal, Repair of Ventral Hernias, was reviewed with regard to recurrence of hernia. Ventral hernias must be operated on with a tension-free technique. It is recommended that hernias larger than 4 cm are repaired with mesh. A randomised, controlled trial has yet to be carried out to determine whether even small hernias should be repaired with mesh. Controlled and uncontrolled studies have shown that the use of mesh to repair larger hernias results in a lower recurrence rate. The operative technique with the mesh placed to bridge the wall defect gives a higher rate of recurrence than does an overlap technique. The overlap of the mesh and its placement in relation to the different layers of abdominal wall are not defined. The laparoscopic operation using the overlap technique and intraperitoneal mesh has shown a lower recurrence rate than the open technique. However, a randomised, controlled study comparing the laparoscopic and open overlap technique over a long follow-up period still needs to be conducted.

Hernia, Ventral↗
PubMed2002

[Biliary pain in genital Chlamydia infection].

We describe a case of clinical signs of acute cholecystitis as a complication to genital Chlamydia infection. Transabdominal ultrasound and magnetic resonance-scanning were normal. Cholescintigraphy showed an obstruction of the ductus cysticus. The patient was treated with antibiotics and two weeks later was without symptoms.

Abdominal Pain↗