[Learning curve in laparoscopic rectum surgery].

Laparoscopic colorectal surgery has become increasingly more common since first being described in a publication in 1990. Despite a multitude of studies about the learning curve in laparoscopic colon surgery, there are almost no such studies with regard to laparoscopic rectum surgery. This paper aims to describe a surgeon's learning curve with regard to laparoscopic rectum surgery.

[Laparoscopic recovery continuity after the Hartmann procedure].

In the period from January 2003 to June 2009 923 complex laparoscopic colorectal procedures were performed by one surgeon. Data was as­sessed prospectively in a database including 152 variables. In 15 patients (10 f, 5 m), with a median age of 61 years (range: 35-83 years), discontinuity resection of the colon was performed including 3 patients with open discontinuity resection of the sigma and 12 patients with laparoscopic Hartmann procedures.

[New perspectives in laparoscopic simulation: from students' skills lab to stress evaluation].

Background: Application of a LapSim-training model in the Students' Skills Lab as well as the objective evaluation of stress in a virtual operating room scenario offer new perspectives in laparoscopic simulation.

Methods: In a Students' Skills Lab , assessment of learning curves of laparoscopic basic skills and complex tasks was carried out with 28 individuals at a LapSim Virtual Reality (VR)-simulator in a training curriculum consisting of 9 units. In addition, in a virtual operating room scenario, stress evaluation was performed with 18 surgeons by means of a sympathicograph and, in that way, the laparoscopic error and complication rate were recorded.

Operative treatment of tibial shaft fractures: a comparison of different methods of primary stabilisation.

Introduction: Segmental fractures of the tibial shaft (AO type 42-C2) often occur after a high energy direct trauma with consecutive severe soft tissue injury and a high rate of open fractures. The blood supply of the intermediate bone fragment can be severely disturbed and therefore operative treatment is demanding. In this retrospective study, we compared three different methods of stabilisation.

Three different types of surgeon-specific stress reactions identified by laparoscopic simulation in a virtual scenario.

Background: Minimally invasive surgery causes higher mental strain for surgeons than conventional surgery and is significantly more stressful in consecutive cases. This study aimed to investigate whether individual stress responses are associated with intraoperative alterations of manual surgical skills and technical errors of the laparoscopic surgeon.

Methods: The LapSim virtual reality simulator was used.