Journal of Indian Association of Pediatric Surgeons
Journal of Indian Association of Pediatric Surgeons
                                                   Official journal of the Indian Association of Pediatric Surgeons                           
Year : 2013  |  Volume : 18  |  Issue : 1  |  Page : 43--44

Live operative workshops: Should we do away with them?

V. V. S Chandrasekharam, Harish Jayaram 
 Department of Pediatric Surgery, Pediatric Urology and MAS Rainbow Children's Hospitals, Hyderabad, India

Correspondence Address:
V. V. S Chandrasekharam
Rainbow Children«SQ»s Hospitals, Hyderabad

How to cite this article:
Chandrasekharam V, Jayaram H. Live operative workshops: Should we do away with them?.J Indian Assoc Pediatr Surg 2013;18:43-44

How to cite this URL:
Chandrasekharam V, Jayaram H. Live operative workshops: Should we do away with them?. J Indian Assoc Pediatr Surg [serial online] 2013 [cited 2020 Aug 5 ];18:43-44
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In a letter published recently, Dr. Kittur [1] expressed many valid concerns regarding the problems with live operative workshops in pediatric surgery. The most recent issue of the journal of laparoendoscopic and advanced surgical techniques (JLAST) has published the results of an IPEG (International Pediatric Endosurgery Group) member survey on this very topic. We wish to share the results of that study since we feel JLAST may not be accessible to most of our readers, and the survey included many of the concerns that Dr. Kittur expressed.

An Internet-based survey on live case demonstrations (LCD) was designed and conducted on behalf of the IPEG Research Committee. [2] In this online-based survey in 2010-2011, all IPEG members were requested to complete a questionnaire including data on personal background and statements on LCD. Participants had to indicate agreement with statements on a scale from 1 (do not agree) to 5 (fully agree). The participants were divided into 2 groups: Performing surgeons (those operating in live workshops) and attendees. Sixty-one performing surgeons and 148 attendees completed the questionnaire. The important results of the survey were as follows:

Eighty-three percent of surgeons indicated elevated stress levels during LCD. Surgeons (3 ± 1.2) and attendees (3 ± 1.4) agreed that LCD may be harmful. Surgeons (2 ± 1.2) and attendees (2 ± 1.3) disagreed that LCD may be beneficial for patients. However, LCD was rated as educationally essential by surgeons (3 ± 1.3) and attendees (3 ± 1.3). Surgeons agreed (3 ± 1.2) that educational benefits of LCD outweigh disadvantages for patients; attendees did not agree (2 ± 1.3). Both surgeons (4 ± 1.4) and attendees (3 ± 1.4) agreed that LCD should continue.Sixty-four % of surgeons and 48% of attendees would consent for LCD in their own child (36% of surgeons and 52% of attendees would not consent)

The authors concluded that their results clearly showed that members of IPEG regarded LCD as an essential part of surgical education. However, LCD did represent a controversial topic among both performing surgeons and attendees during LCDs in pediatric surgery. The majority of the IPEG community appeared willing to continue LCD during pediatric surgical meetings. If IPEG decided to go on with LCD, attention has to be drawn to patient safety issues and ethical considerations in this field. The authors strongly recommended establishing an ethical code of conduct for LCD following the existing versions of other societies, but adapted for pediatric surgery.

We recently conducted a very successful live operative workshop in Hyderabad for PESI 2012, where many major endosurgical procedures were demonstrated. We can vouch that there was not a single complication in any child that was operated in that workshop. This was possible because every surgeon operated only those cases that they were most comfortable operating in the field of their best expertise. This required meticulous planning right from the very beginning and down to minute details. The international faculty was chosen keeping in mind the cases that would be demonstrated in the workshop. The details of the cases were discussed with the operating surgeons many weeks before; they were requested to carry with them any special equipment that they considered vital for a particular procedure. In the end, the workshop had a positive influence on the surgical expertise of many of the attendees; many of our colleagues have successfully put into practice the procedures that they learnt in that workshop.

Considering the above, we feel that there is a place for live operative workshops in pediatric surgical learning. However, great attention has to be paid regarding patient safety and ethical issues, which should not be compromised. We suggest that IAPS may form a committee that supervises all live operative workshops conducted under IAPS banner so that such workshops may be beneficial to the surgeons without being harmful to the patients.


1Kittur D. Live operative workshops: Should we do away with them? J Indian Assoc Pediatr Surg 2012;17:143.
2Dingemann J, Laje P, St Peter SD, Ure BM. IPEG survey on live case demonstrations in pediatric surgery. J Laparoendosc Adv Surg Tech 2012;22:705-9.