A Structured Program for Teaching Pancreatojejunostomy Outside the Operating Room
Abstract Background: Pancreatojejunostomy (PJ) is one of the most difficult and challenging abdominal surgical procedures. Most trainees learn this procedure in the operating room (OR) because there are no appropriate training systems available outside the OR. This extends the learning curve and may affect patient safety. We developed a structured program for teaching PJ to increase training opportunities outside the OR. Methods: We have created this structured program to help trainees acquire both didactic knowledge and technical skills to perform PJ. A manual was created to provide general knowledge about PJ and the specific PJ procedure used in our institution. Based on questionnaires completed by trainers and trainees, the procedure for PJ was divided into twelve steps and described in detail. After creating the manual, we developed organ models, needles and a frame box for simulation training.Results: Trainees learn about PJ by reading the procedure manual, acquiring both general and specific knowledge. We conducted simulation training outside the OR using the training materials created for this system. Training was performed with participants referring to the procedure manual while performing the simulation training. They simulate the procedure with surgical instruments as both primary and assistant surgeon. After finishing the anastomosis, trainees inspect the resulting structures from all angles including the posterior side and intraluminally, which cannot be observed during the actual operation. Conclusion: We developed a structured program for teaching PJ. By implementing this program, it is expected that a trainee’s learning curve will be shortened while ensuring patient safety.