Murielle Brohez, MD
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Transcript of Murielle Brohez, MD
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Murielle Brohez, MD
Minimal Invasive Surgery
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Digital CenturyDigital Century
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Video Games:Video Games:an Advantage for Young MIS Surgeonsan Advantage for Young MIS Surgeons
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Positive Effects from Previous Positive Effects from Previous StudiesStudies
Early Studies evaluated psychomotor skills Video gamers showed:
superior eye-hand coordinationfaster reaction timessuperior spatial visualization skillsincreased capacity for visual attention and
spatial distribution
Griffith, Voloschin, Gibb, Bailey; Perceptual and Motor Skills,19832. Yuji H; Perceptual and Motor Skills, 1996 3. Dorval, Pepin; Perceptual and Motor
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The Impact of Video Games on Training The Impact of Video Games on Training SURGEONS in the 21st CenturySURGEONS in the 21st Century
Rosser Jr, MD; et al.Rosser Jr, MD; et al.
• Arch Surg. 2007;142(2):181-186.
• Video games are extensively integrated into popular culture
• Anecdotal observations of young surgeons
suggest that video game play contributes to performance excellence in laparoscopic surgery
• Hypothesis There is a potential link between video game play and laparoscopic surgical skill and suturing
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• Design Cross-sectional analysis of the performance of surgical residents and attending physicians participating in the Rosser Top Gun Laparoscopic Skills and Suturing Program (Top Gun)
• Participants Thirty-three residents and attending physicians participating in Top Gun from May 10 to August 24, 2002.
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• Main Outcome Measures The primary outcome measures were compared between participants' laparoscopic skills and suturing capability, video game scores, and video game experience.
• Results - Video Game players 33% better (P<.005)- More than 3 h/wk >42 % better (P<.01) - Current video game players 32% fewer errors (P=.04),
performed 24% faster (P<.04), and scored 26% better overall (time and errors) (P<.005)
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ConclusionsConclusions
- Video game skill correlates with laparoscopic
surgical skills
- Training curricula that include video games may help thin the technical interface between surgeons and screen-mediated applications, such as laparoscopic surgery
- Video games may be a practical teaching tool to help train surgeons
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Benefits of LaparoscopyBenefits of Laparoscopy
• Benefits of laparoscopy are mostly derived postoperatively pain– attenuated stress response– earlier return to ambulation after lap
procedures postoperative complications + quicker return to full activity
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Historical BackgroundHistorical Background
• 1929 - Heinz Kalk, a german gastroenterologist
• Up to 1970 – Jurgen Nord, USF
• 1987 – Phillipe Mouret, Lyons France
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HerniaHernia
• More than 600,000 hernias are repaired annually in the United States
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Hernia Surgery - HistoryHernia Surgery - History
Edwin Smith Papyrus
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Medieval TimesMedieval Times
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Beuk repairBeuk repair
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Techniques of Traditional Open Techniques of Traditional Open RepairRepair
-Lucas-Championnière 1881
-Bassini 1889
-Lotheissen 1898
-McVay 1942
-Shouldice 1945
-Lichtenstein 1987
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Laparoscopic RepairLaparoscopic Repair
• ? Less pain
• ? Can it be done
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Anterior Abdominal WallAnterior Abdominal Wall
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Totally Extra PeritonealTotally Extra Peritoneal
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TEP anatomyTEP anatomy
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Mesh layoutMesh layout
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Body ContourBody Contour
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TEP VideoTEP Video
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TEPTEP
• Indications:- Recurrent- Bilateral- Active lifestyle
• Contraindications:- Strangulated- Hypotensive/sepsis
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TEP post-opTEP post-op
• SDS
• Minimal narcotic intake
• Return to work 3-5 days
• Return to golf / running 3-5 days
• Return to full activity within 10-15 days
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MIS at SOMCMIS at SOMC
• Hernias• Appendectomy• Cholecysctetomy• Colectomy• Anti-reflux Surgery – Nissen Fudoplication• Diagnostic Laparoscopy• Lysis of Adhesions• Biopsies
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Thank YouThank You