OC-053 POSTERIOR COMPONENT SEPARATION AND THE USE OF BOTULINUM TOXIN IN ABDOMINAL WALL RECONSTRUCTION: NEED TO LEARN THE TECHNIQUE DURING THEIR RESIDENCY?

Abstract

Abstract Tittle Posterior component separation and the use of botulinum toxin in abdominal wall reconstruction: need to learn the technique during their residency? Aim We aim to evaluate the transversus abdominis release (TAR) and the use of botulinum toxin A (BTA) in abdominal wall reconstruction learning curve based on proper identification of muscle layers and nervous component in the surgery and by US. Material and Methods Prospective study including patients submitted to TAR and preoperative BTA injection (n 15), perform by 3 seniors surgeons and a group of residents (10). Resident's acquisition and development of fundamental skills were evaluated by comparing pre (theorical: identification of muscle layers and by US and in images of the surgeries) and post-course (identification of muscle layers by US, BTA injection, and in surgery) assessment measurements. Results Out of 20 captured attempts by novices, 20 successful trials were evaluated. An increase in identification post-course of the abdominal wall components by US was shown in comparison of the attempt´s pre-course (p ≤ 0.023) and application of BAT in the patients was success in all the patients. Components of the abdominal wall (muscles layers and nervous component) improve after theorical course (p ≤ 0.048). Conclusions Correct identification by US and images of all the components during training showed to be effective in determining acquisition and development of basic surgical skills. The outcomes indicated that skills in vivo improved and that this training should therefore be part of the regular residency training program.