Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
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The Aachen model is a practical mode in teaching and advanced training, which is closely geared to the areas of academic acquisition and training. During medical education optional student courses with constitutive curricula offer practical points of contact to the surgical department at all times. Besides improvement of manual training the aims are enhancing interests and acquisition of talents. ⋯ Next to the formal guidelines of the curriculum, education logbook and progression conversations, quality, transparency and reliability are particularly emphasized. An evaluation of both the reforms and the surgical trainers is still to be made. In addition procurement of an affirmative occupational image is essential.
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In recent years minimally invasive surgical techniques in children have made substantial progress. The feasibility and safety of a wide spectrum of laparoscopic and thoracoscopic procedures have been confirmed in numerous studies. ⋯ The present article reviews information on established as well as feasible but not yet established surgical procedures. The discussion of potential hemodynamic, respiratory and organ perfusion effects of the CO(2) pneumoperitoneum and the notation of special logistic aspects should support the reader in the process of decision-making to schedule infants and children for minimally invasive surgery.
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Surgical access trauma in thyroidectomy has been minimized by the adoption of minimally invasive techniques. Extracervical approaches moved the incision lines outside of the visible neck region. However, because of the extensive dissection they no longer comply with the term minimally invasive. Therefore, our goal was to reduce the access trauma and establish a non-traumatic approach according to surgical planes for endoscopic minimally invasive thyroidectomy: the transoral approach. ⋯ Minimum impact and a gentle dissection according to anatomical planes are the rational for the transoral route to the thyroid gland. Thus based on anatomical dissections the foundations of a novel procedure in the context of natural orifice surgery (NOS) could be established.