| Validation of specific criteria of performance evaluation for each procedure. |
|
Inguinal Herniorrhaphy
|
| a. Correctly identifies the structures corresponding to the inguinal ligament, conjoint tendon, inguinal triangle? |
| b. Properly identifies the anatomical relations with the femoral vessels? |
| c. Properly handles the hernia sac? |
| d. Properly Fixes the mesh? |
|
Gastrostomy
|
| a. Properly incises the abdominal wall for Gastrostomy? |
| b. Chooses a suitable gastric segment for positioning of the catheter? |
| c. Properly fixes the catheter to the stomach? |
| d. Properly fixes the catheter to the abdominal wall? |
|
Incisional Herniorrhaphy
|
| a. Properly prepares the aponeurosis for fixing the mesh? |
| b. Properly fixes the mesh? (adequate distance from the aponeurotic edges, adequate distance between stitches) |
| c. Properly handles the contents of the hernia sac? |
| d. Properly handles the hernia sac?(resection of excess, base ligation, possibility of use of the excess for abdominal cavity insulation) |
|
Colostomy
|
| a. Chooses the correct abdominal wall spot for colostomy positioning? |
| b. Exercises caution not to let the colon in tension? |
| c. Incises the colon in proper extension? |
| d. Adequately performs the lateral colostomy? (early maturation)* |
|
Enterectomy
|
| a. Properly uses linear staplers for suture of small bowel resection? |
| b. Properly uses intestinal clamps? |
| c. Properly performs manual entero-enteric anastomosis? |
| d. Observes the care required for the success of the anastomosis. (angles' stitches, vascularization, tension on suture line) |
|
Laparoscopic Cholecystectomy
|
| a. Performs the first abdominal puncture with the due care? |
| b. Recognizes the anatomical repairs for surgical safety? (dissection along the gallbladder, Calot's Triangle exposure, exposure of junction of cystic duct and choledocus) |
| c. Properly dissects the gallbladder pedicle (cystic duct, choledocus, cystic artery) |
| d. Uses cautery with the required caution? (low current, away from the main biliary tree area) |
|
Biliodigestive derivation with jejunum
|
| a. Appropriately chooses the bowel segment for anastomosis? (proper distance to excluded loop) |
| b. Properly incises biliary tree and bowel loop? |
| c. Properly performs the anastomosis? (no tension) |
| d. Appropriately positions the cavity drain? |
|
Partial Gastrectomy
|
| a. Recognizes stomach's vascular pedicles? (left gastric and celiac trunk; right gastric, left and right gastroepiploic, short vessels) |
| b. Recognize stomach's anatomical divisions? |
| c. Adequately performs vascular ligatures? (type of suture, type of ligature) |
| d. Adequately performs the reconstruction of transit? (Roux-en-Y, B I or B II, submucosal hemostasis, equal distance from the edges). |
|
Partial Colectomy
|
| a. Recognizes anatomical landmarks and vascular pedicle of segment to be resected. |
| b. Adequately performs vascular ligatures? |
| c. Properly uses linear and circular staplers? |
| d. Adequately performs anastomosis for the reconstruction of the transit? (repairs in the angles, extramucosal suture, mesenterium position, absence of tension) |
|
Simple Hepatectomy
|
| a. Correctly recognizes the liver vascularization landmarks? |
| b. Adequately performs digitoclasia, ligatures and resection? |
| c. Recognizes the intrahepatic ducts and ligates them separately? |
| d. Adequately uses the different methods for hemostasis? (monopolar current, ultrasonic, argon scalpel, biological glues, etc.) |
|
Distal Pancreatectomy
|
| a. Properly recognizes and dissects planes for access to the pancreas? |
| b. Properly identifies splenic artery and vein? |
| c. Adequately performs parenchymal suture? |
| d. Adequately treats the pancreatic duct? |
| * Item withdrawn from the questionnaire after validation by experts. |
