577 EFFECTIVENESS OF CADAVER SURGICAL TRAINING FOR THORACOSCOPIC ESOPHAGECTOMY

Abstract Thoracoscopic esophagectomy (TE) requires advanced surgical skills. Learning TE only through conventional on-the-job- training (OnJT) is difficult. Therefore, it is necessary to establish a safe and efficient educational program to learn the procedure. In our department, cadaver surgical training (CST) has been used to learn our standard procedure of prone position TE. In this presentation, we describe the usefulness of CST as an education tool for the surgical training of TE. Methods Cadavers embalmed by Thiel fixation were used for the training. To be eligible, the trainee must possess the surgical skills to perform laparoscopic gastrectomy and have the motivation to perform TE. Our program included self-study and lectures and evaluating the trainee using our original manual and evaluation sheet. During the CST practice, one cadaver was assigned to each trainee, and the trainee experienced whole procedure both as the operator and the assistant. After the training, feedback was given using the same evaluation sheet. Results Ten surgeons were evaluated using the technical evaluation sheet (12 items, 5 points per item, total 60 points), the average of the total points increased from 23 to 43 points after the training. The item with largest increase and highest score after the training was “thoracic duct dissection” (1.8 to 4.0). The item “Left recurrent laryngeal nerve (RLN) dissection” was the worst in both pre- and post-training as the average score was only increased from 1.6 to 3.1. On the other hand, the item “Right RLN dissection” score showed a moderate change from 1.7 to 3.5. Conclusion CST for mastering the whole surgical procedure of TE was useful in terms of overall quality of the operative performance. On the other hand, it seemed to be insufficient for mastering the lymph node dissection around the left recurrent laryngeal nerve. Development of a comprehensive education program combined with learning the whole procedure by CST and repetition training for a highly difficult procedure by simulation is necessary.