Journal of Gastrointestinal & Digestive System
Open Access

Abstract

The current training of residents in laparoscopic surgery, in Latin America, is performed in operating room (OR) with the patient, which predisposes risk of many complications. For this reason, we believe in training, which was previously performed in the laboratory, through theoretical and practical progressive activities that allow the resident to learn the correct handling of basic laparoscopy and leaves them ready for the best learning and advanced courses. CEPCEA is a nongovernmental, nonprofit organization dedicated to the study, teaching and training of laparoscopic surgery as the main source to provide social assistance for poor people. We have developed a teaching system based on PBL (Problem-Based Learning), the Japanese KAIZEN Method (Classification, Order, Cleaning, Discipline and Standardization) and permanent creation of TIPS. We combined the best of each continent: The use of FLS box of American origin, where coordination skills, expert hands independence in both hands and precision performing intracorporeal knots, endoloop and roeder knots in inanimate objects were developed â�?�?on dryâ�?; in the same way, we use the endotrainer of European origin for skills development â�?�?on moistâ�?, in chicken neck, with the same instruments that we do it â�?�?on dryâ�?. We teach the ideal placement of the Veress needle and trocars, development and control of the third dimension with the angled laparoscope (30�?° and 45�?°), the perpendicularity (three dimensions), placing and handling of Kehr Drain, whitening, good use of monopolar and bipolar energy and how to avoid complications and work with quality indicators and continuous quality improvement in laparoscopy. In the theoretical part, we teach meticulously: The use and selection of cameras, laparoscopes, monitors, light cables, light sources, energy sources, accuracy and use of pressures of the aspirator, insufflator data interpretation, details of the Veress needle, trocars, materials and equipment, pathophysiology of CO2, alternative gases and ergonomy. In swine, we apply all the techniques and theories learned during the course as we would apply in a human being. Admission to OR in human is done by trainees as assistant. CEPCEA Training Center is located in Piura, northern of Peru, now in downtown. It is of 200 square metres. In addition we also have 20,000 square metres of area, where we have a project to build the â�?�?Laparoscopic Surgery International Centreâ�? with own surgery and hospitalization rooms, where training for residents of laparoscopic surgical specialties will be performed with national and foreign teachers. We have academic supports like Framework and Specific Agreements with the National University of Piura (Peru), Specific Agreement with the University of Loja (Ecuador), Medical College of Peru and the Peruvian Society of Endoscopic Surgery (SPCE), Doctoral Thesis Author, yet in action. To date, we have over 200 trainees in which usually 4 trainees, 1 time per month come from Ecuador, Colombia, Guatemala and El Salvador.

Biography

Edmundo Dedios is the Chief of the Surgery Department at Jorge Reategui Delgado Hospital II – EsSalud, Piura from January 2006 till now. He was Chief of Surgery at Service Jorge Reategui Delgado Hospital II – EsSalud, Piura from July 2004 to December 2005. He worked as a Medical Manager at Assistential – EsSalud Piura from April 23th to June 15th, 2004. Before that, he was the Director of Jorge Reategui Delgado Hospital – EsSalud – Piura from September 7th, 2001 to April 22nd, 2004. He was also the General Director of Regional Direction of Health, Piura from October 14th, 2000 to February 14th, 2001. He served as the Director of Jorge Reategui Delgado Hospital– EsSalud, Piura from September 7th, 1998 to October 29th, 1999. He was Director of Sullana Hospital from July 26th, 1988 to December 1990 and before that he was the Director of La Unión Policlínic from July 1st 1983 to December 31st, 1985.

Email: ed_dedios@hotmail.com