Background: Laparoscopic surgery is a very modern and sophisticated method of surgical treatment and as such requires different equipment, different equipment layout, surgical team and a special patient position. The first human laparoscopy was performed by von Jacobeus in 1910 in Sweden, to diagnose ascites and this method was mainly used by gastroenterologists. Since 1980, after the first laparoscopic surgeries, such as laparoscopic appendectomy, cholecystectomy, laparoscopic colon surgery etc., surgeons have taken a leading role in the application of laparoscopy. Objective: A laparoscopic surgeon should work slowly and safely, stop work if he does not have a good examination of the operative field, and his technique is dominated by good control of hemostasis. Ergonomic specifics of instruments, equipment, and specific position of the surgeon during the operation are important in laparoscopy. The application of laparoscopic surgery in patients with COVID-19 infection is the topic of this article. Methods: We analyzed all patients operating laparoscopically who were simultaneously infected with COVID-19 virus. Results/Diskussion: Laparoscopic surgery has numerous advantages compared to open surgery, which has been established in clinical studies: faster recovery of patients, fewer complications, less pain, aesthetic results are better, and the economic effects are on the side of laparoscopy. The application of laparoscopic surgery at the time of COVID-19 infection requires some answers that we do not yet have. Is there a possibility of contamination of the surgical team with gas from the abdomen? Does increased intra-abdominal pressure adversely affect a COVID-19 infected patient? All of this requires the larger clinical trials that await us. Conclusion: Laparoscopic surgery has an advantage over open surgery in standard conditions. In patients infected with COVID-19, the use of laparoscopic surgery is associated with certain aggravating factors that require additional clinical trials.
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) still has a relatively high complication rate, underscoring the importance of high-quality training. Despite existing guidelines, real-world data on training conditions remain limited. This pan-European survey aims to systematically explore the perceptions surrounding ERCP training. METHODS: A survey was distributed through the friends of United European Gastroenterology (UEG) Young Talent Group network to physicians working in a UEG member or associated states who regularly performed ERCPs. RESULTS: Of 1035 respondents from 35 countries, 649 were eligible for analysis: 228 trainees, 225 trainers, and 196 individuals who regularly performed ERCP but were neither trainees nor trainers. The mean age was 43 years, with 72.1% identifying as male, 27.6% as female, and 0.3% as non-binary. The majority (80.1%) agreed that a structured training regimen is desirable. However, only 13.7% of trainees and 28.4% of trainers reported having such a structured program in their institutions. Most respondents (79.7%) supported the concept of concentrating training in centers meeting specific quality metrics, with 64.1% suggesting a threshold of 200 annual ERCPs as a prerequisite. This threshold revealed that 36.4% of trainees pursued training in lower-volume centers performing <200 ERCPs annually. As many as 70.1% of trainees performed <50 annual ERCPs, whereas only 5.0% of trainers performed <50 ERCPs annually. A low individual trainee caseload (<50 ERCPs annually) was more common in lower-volume centers than in higher-volume centers (82.9% vs. 63.4%). CONCLUSIONS: The first pan-European survey investigating ERCP training conditions reveals strong support for structured training and the concentration of training efforts within centers meeting specific quality metrics. Furthermore, this survey exposes the low availability of structured training programs with many trainees practicing at lower-volume centers and 71% of all trainees having little hands-on exposure. These data should motivate to standardize ERCP training conditions further and ultimately improve patient care throughout Europe.
- MeSH
- Cholangiopancreatography, Endoscopic Retrograde * standards adverse effects MeSH
- Adult MeSH
- Gastroenterology * education MeSH
- Clinical Competence standards MeSH
- Middle Aged MeSH
- Humans MeSH
- Surveys and Questionnaires statistics & numerical data MeSH
- Education, Medical, Graduate * standards methods MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Europe MeSH
