Resident training in laparoscopic colorectal surgery: role of the porcine model.

Background: Laparoscopic colorectal surgery (LCRS) is an effective option for the treatment of various colorectal conditions. However, its implementation in surgical practice is still limited, and there are no clear guidelines for residency training requirements or evaluation of the level of expertise. The aim of this study was to assess the level of practical expertise of senior residents regarding LCRS in an animal porcine model.
Methods: At the Department of Biosciences of Rome, Tecnopolo of Castel Romano, 50 senior residents underwent training sessions on a porcine model under the direction of attending laparoscopic surgeons. A total of 20 residents underwent box trainer preparation before starting the surgical procedure on the animal model; and a group of 6 repeated the course 3 months after the first session.
Results: Overall, 90 % of the residents needed help during the surgical procedures, and only 9 residents (18 %) showed a high level of confidence when performing the surgery. Video-trainer preparation helped residents increase their laparoscopic ability (p = 0.04). Residents who attended two training courses showed significant improvement regarding the duration of the procedures, rate of complications, and the need of a tutor.
Conclusions: The study demonstrated that the experience of senior surgical residents in regard to performing LCRS is less than ideal. A national training program should carefully consider the present quality of training in Italy and attempt to develop and integrate alternative methods for teaching laparoscopic surgery, perhaps by having an animal model laboratory.