Hepato-pancreatico-biliary surgical education: rediscovery of cadaver based teaching

Rajesh Pendlimari, Nagesh N. Swamygowda, Sushrutha C. S.


Background: As the classical surgical training (mentor–trainee) model is not feasible in the current era of surgical training and simulation model for training young residents is proven, the advanced surgical residents may benefit from cadaver based surgical teaching.

Methods: International Hepato-Pancreato-Biliary Association India 2017 provided great opportunity to organize basic hepato-pancreatico-biliary (HPB) anatomy workshop clubbed with HPB radiology and other advanced surgical techniques. It was attended by advanced surgical residents and practicing junior faculty. Post-program survey was conducted and results implied.

Results: 131 surgeons attended and 90 (80% residents, 15.6% practicing surgeons) completed the survey. Majority (97.5%) felt that the HPB anatomy was adequately demonstrated by spending enough time for dissection techniques and discussion. Most (84.7%) never attended cadaveric dissection during or after their training program. 95.1% think that dedicated anatomy or dissection teaching sessions are either very useful or useful for their level of surgical training. All participants found cadaveric workshop either very useful (73.3%) or useful (26.7%) learning tool. Majority (73.3%) felt that demonstrated HPB procedures were appropriate for their level. All participants (100%) felt that cadaveric workshops will improve their surgical skills and many (93.4%) felt these improve their confidence in operation theatres.

Conclusions: This cadaver based HPB teaching program is an initial step for unique HPB surgical education and useful adjunct for advanced surgical trainees in modern era. Residents consider this as good learning tool and possibly improve surgical skills and confidence. The translation of cadaver based HPB surgical learning into better surgical care needs evaluation in future.


HPB Surgery, Education, Cadaver training

Full Text:



Rogers DA, Elstein AS, Bordage G. Improving continuing medical education for surgical techniques: applying the lessons learned in the first decade of minimal access surgery. Ann Surg. 2001;233(2):159-66.

Bhattacharya S. Live surgical workshops: Educational or vain glitz. Indian J Plast Surg. 2013;46(3):453-5.

Ogan K, Jacomides L, Shulman MJ, Roehrborn CG, Cadeddu JA, Pearle MS. Virtual ureteroscopy predicts ureteroscopic proficiency of medical students on a cadaver. J Urol. 2004;172(2):667-71.

Supe A, Dalvi A, Prabhu R, Kantharia C, Bhuiyan P. Cadaver as a model for laparoscopic training. Indian J Gastroenterol. 2005;24(3):111-3.

Mutzbauer TS, Munz R, Helm M, Lampl LA, Herrmann M. Emergency cricothyrotomy--puncture or anatomical preparation? Peculiarities of two methods for emergency airway access demonstrated in a cadaver model. Anaesthesist. 2003;52(4):304-10.

Nesbitt CI, Birdi N, Mafeld S, Stansby G. The role of simulation in the development of endovascular surgical skills. Perspect Med Educ. 2016;5(1):8-14.

Sidhu RS, Park J, Brydges R, MacRae HM, Dubrowski A. Laboratory-based vascular anastomosis training: a randomized controlled trial evaluating the effects of bench model fidelity and level of training on skill acquisition. J Vasc Surg. 2007;45(2):343-9.

Issenberg SB, McGaghie WC, Hart IR, Mayer JW, Felner JM, Petrusa ER, et al. Simulation technology for health care professional skills training and assessment. JAMA. 1999;282(9):861-6.

Davies J, Khatib M, Bello F. Open surgical simulation--a review. J Surg Educ. 2013;70(5):618-27.

Gaarder C, Naess PA, Buanes T, Pillgram-Larsen, J. Advanced surgical trauma care training with a live porcine model. Injury. 2005;36(6):718-24.

Jensen AR, Wright AS, McIntyre LK, Levy AE, Foy HM, Anastakis DJ, et al. Laboratory-based instruction for skin closure and bowel anastomosis for surgical residents. Arch Surg. 2008;143(9):852-8.

Lentz GM, Mandel LS, Goff BA. A six-year study of surgical teaching and skills evaluation for obstetric/gynecologic residents in porcine and inanimate surgical models. Am J Obstet Gynecol. 2005;193(6):2056-61.

Triantafyllou K, Lazaridis LD, Dimitriadis GD. Virtual reality simulators for gastrointestinal endoscopy training. World J Gastrointest Endosc 2014;6(1):6-12.

Holubar SD, Hassinger JP, Dozois EJ, Camp JC, Farley DR, Fidler JL, et al. Virtual pelvic anatomy and surgery simulator: an innovative tool for teaching pelvic surgical anatomy. Stud Health Technol Inform. 2009;142:122-4.

Lonn L, Edmond JJ, Marco J, Kearney PP, Gallagher AG. Virtual reality simulation training in a high-fidelity procedure suite: operator appraisal. J Vasc Interv Radiol. 2012;23(10):1361-6.