Training in Minimally Invasive Pancreatic Resections: a paradigm shift away from "See one, Do one, Teach one"

HPB (Oxford). 2017 Mar;19(3):234-245. doi: 10.1016/j.hpb.2017.01.016. Epub 2017 Feb 10.


Background: Increased incorporation of minimally invasive pancreatic resections (MIPR) has emerged into hepato-pancreato-biliary practice, however, no standardization exists for its safe adoption. Novel strategies are presented for dissemination of safe MIPR.

Methods: An international State-of-the-Art conference evaluating multiple aspects of MIPR was conducted by a panel of pancreas experts in Sao Paulo, Brazil on April 20, 2016. Training and education issues were discussed regarding the introduction of novel strategies for safe dissemination of MIPR.

Results: The low volume of pancreatic resections per institution poses a challenge for surgeons to overcome their MIPR learning curve without deliberate training. A mastery-based simulation and biotissue curriculum can improve technical proficiency and allow for training of surgeons before the operating room. Video-based platforms allow for performance reporting and feedback necessary for coaching and surgical quality improvement. Centers of excellence with training involving a standardized approach and proctorship are important concepts that can be utilized in various formats internationally.

Discussion: Surgical volume is not sufficient to ensure quality and patient safety in MIPR. Safe adoption of these complex procedures should consider innovative mastery-based training outside of the operating room, novel video based coaching techniques and prospective reporting of patient data and outcomes using standardized definitions.

Publication types

  • Congress

MeSH terms

  • Clinical Competence
  • Congresses as Topic
  • Curriculum
  • Education, Medical, Graduate / methods*
  • Education, Medical, Graduate / standards
  • High Fidelity Simulation Training
  • Humans
  • Laparoscopy / adverse effects
  • Laparoscopy / education*
  • Laparoscopy / standards
  • Learning Curve
  • Pancreatectomy / adverse effects
  • Pancreatectomy / education*
  • Pancreatectomy / standards
  • Pancreaticoduodenectomy / adverse effects
  • Pancreaticoduodenectomy / education*
  • Pancreaticoduodenectomy / standards
  • Quality Improvement
  • Quality Indicators, Health Care
  • Robotic Surgical Procedures / adverse effects
  • Robotic Surgical Procedures / education*
  • Robotic Surgical Procedures / standards
  • Surgeons / education*
  • Surgeons / standards
  • Treatment Outcome