The ladder of learning in exstrophy closure — A 5 year initial faculty experience
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Read the article on jpedsurg.org ↗Article · Aug 2019 · 1 min read
In brief
In brief
This study examines the learning curve for bladder exstrophy closure, tracking a junior surgeon's progression from fellowship through four years of independent practice. Survey data from 25 fellows reveals limited case exposure across the field, while detailed operative logs demonstrate significant improvement in surgical efficiency (485 to 309 minutes) through mentored experience with 48 cases.
Written by the GCMD Library team from the article.
Purpose
Closure of bladder exstrophy is one of the most complex reconstructive procedures. Basic concepts of these operations, as well as their subtle nuances, require years of experience. However, the volume of these cases is low. The authors describe the experience of a junior surgeon learning the details of exstrophy closure during fellowship and her initial career.
Methods
Fellows graduating in 2014 were surveyed for their exstrophy experience during fellowship and the following four years. Operative logs of the junior faculty member were reviewed during the same time. Average operative times were calculated for each year.
Results
Seventeen of the 25 fellows responded to the survey. Eight surgeons did one or fewer exstrophy closures during fellowship; 14 did one or fewer closures as an attending. The junior faculty member assisted in 18 closures as a fellow and 48 exstrophy closures during the next four years. Average operative time decreased from 485 to 309 min from attendingship year one to four.
Conclusions
There are subtle details inside and outside of the operating room required to ensure a successful outcome in this important step of exstrophy reconstruction. Working alongside senior colleagues is essential to allow the junior surgeon to ascend this ladder of mastering exstrophy closure.
Type of study
Diagnostic.
Level of evidence
V