Published 2019-07-11
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Abstract
Introduction: Traditionally, the main surgical technique to access the abdominal cavity has been midline incision laparotomy, being postoperative complications a main concern. Proper teaching-learning methods could help improving the success of this procedure.
Aim: Establish an expert’s consensus throughout the Delphi Methodology regarding the main steps that need to be considered in a midline laparotomy.
Materials and Method: Literature review was conducted, 37 steps were identified and grouped in 3 sections; preparation of the skin, opening incision, and closure. These steps were evaluated online by surgeons of 7 teaching hospitals in Chile.
Results: Consensus was reached in two rounds, 28 of the 37 steps were identified as important or very important for the procedure.
Discussion: There is a high level of agreement in steps related to preparation of the skin and opening incision. However, there is not a consensus regarding closure of the peritoneum and fascia in one or more layers, being a case to case decision.
Conclusions: Establishment of 28 standardized steps constitutes a contribution to resident teaching programs and the development of simulation materials as an active learning strategy. Satisfactory learning outcomes have a direct impact in the success of the procedure and a lower rate of complications.