研究活動情報

• Long-term trends and surgical patterns in recurrent groin hernia repair in Japan: insights from the National Clinical Database (2022-2024).
  Masanori Sato; Hiroyuki Yamamoto; Saseem Poudel; Itsuro Nagae; Taketo Matsubara; Tatsuya Tazaki; Tsuyoshi Takagi; Ken Shirabe; Hideki Ueno; Takehiro Hachisuka; Kyosuke Miyazaki
  Hernia : the journal of hernias and abdominal wall surgery, 30, 1, 2026年04月17日, ［国際誌］
  英語, 研究論文（学術雑誌）
• Trends in groin hernia repair in Japan: analysis of the 2023 annual report from the National Clinical Database.
  Masanori Sato; Hiroyuki Yamamoto; Saseem Poudel; Itsuro Nagae; Taketo Matsubara; Tatsuya Tazaki; Tsuyoshi Takagi; Ken Shirabe; Hideki Ueno; Takehiro Hachisuka; Kyosuke Miyazaki
  Surgery today, 2026年03月10日, ［国内誌］
  英語, 研究論文（学術雑誌）
• Longer hours, limited returns? a post-hoc National survey analysis of overtime hours during surgical training in Japan.
  Yoshiko Yamaoka-Fujikawa; Yoshiyuki Kiyasu; Saseem Poudel; Takashi Kohmura; Jun Watanabe; Daisuke Koike; Naohiro Yamamoto; Chiaki Suda; Atsushi Tanikawa; Mitsue Saito; Norihiko Ikeda; Akinobu Taketomi
  Surgery today, 2026年01月20日, ［国内誌］
  英語, 研究論文（学術雑誌）
• Human factors and team safety in robotic-assisted surgery: a narrative review of ergonomic risks and educational implications.
  Keita Ishido; Saseem Poudel; Zen Naito; Akitaka Motoyoshi; Kaito Sano; Satoshi Hirano
  Journal of robotic surgery, 20, 1, 128, 128, 2025年12月29日, ［国際誌］
  英語, 研究論文（学術雑誌）, BACKGROUND: Robot-assisted surgery (RAS) has revolutionized minimally invasive surgery through enhanced dexterity, precision, and three-dimensional visualization. However, as surgeons become physically separated from the operative field, new risks emerge, including staff injuries, arm collisions, communication failures, and diminished situational awareness. This review aimed to synthesize current evidence on ergonomic, cognitive, and non-technical factors influencing staff safety in RAS. METHODS: A narrative review synthesized English-language studies published until 2025 on staff safety, arm interference, and non-technical skills (NTS) in RAS. Literature was searched in PubMed, Scopus, and Embase using terms such as robotic surgery, bedside assistant, arm collision, injury, workflow disruption, human factors, and NTS. Eligible publications included case reports, observational studies, ergonomic analyses, and educational frameworks. Data were grouped into four domains: (1) ergonomic and cognitive challenges, (2) staff injuries and near-misses, (3) NTS deficits, and (4) educational countermeasures. RESULTS: RAS introduces ergonomic and cognitive stressors (restricted workspaces, multiple arms, limited visibility, and loss of tactile feedback), causing injuries such as hand entrapment and arm collisions. FDA MAUDE registry reported over 1,300 injuries and 8,000 device malfunctions, approximately 10% involving staff. Cognitive analyses showed console surgeons' visual immersion reduced team awareness and coordination. Curricula focus on console skills but underemphasize NTS. Interventions such as dual-console mentoring, simulation-based teamwork, and structured NTS coaching improved awareness and reduced workload stress. CONCLUSIONS: RAS enhances precision but introduces human-factor risks. Sustainable safety requires integrating ergonomics, NTS, and communication into robotic training through simulation, feedback, and reflection-ensuring innovation supports both performance and humanity.
• Assessing the impact and effectiveness of the Japanese surgeons as educators program: a faculty development initiative for surgical educators in Japan
  Akihiro Suzuki; Saseem Poudel; Masanori Isobe; Akihiko Oshita; Ken Imai; Hideki Takami; Hisakazu Hoshi
  GLOBAL SURGICAL EDUCATION - JOURNAL OF THE ASSOCIATION FOR SURGICAL EDUCATION, 5, 1, 2025年12月17日
  英語, 研究論文（学術雑誌）
• Development of Nontechnical Skills Assessment Tool and The Validation Study for Laparoscopic Inguinal Hernia Repair.
  Zen Naito; Saseem Poudel; Keita Ishido; Yo Kurashima; Yoichi M Ito; Satoshi Hirano
  Journal of surgical education, 83, 2, 103799, 103799, 2025年12月04日, ［国際誌］
  英語, 研究論文（学術雑誌）, UNLABELLED: Nontechnical skills, such as situational awareness and decision-making, are essential for safe and efficient surgical performance. Although the Nontechnical Skills for Surgeons (NOTSS) framework provides a structured approach, it lacks procedure-specific assessment tools. There remains a significant gap in standardized methods for evaluating and training nontechnical skills in specific surgical procedures. OBJECTIVE: To develop and validate a novel assessment tool, KUDAS-TAPP (Kurashima Decision-making and Situation awareness - Trans Abdominal Preperitoneal approach), specifically designed to evaluate nontechnical skills in the TAPP procedure, focusing on situational awareness and decision-making. DESIGN AND SETTING: Under the supervision of expert hernia surgeons, we developed the KUDAS-TAPP as an assessment tool for nontechnical skills in TAPP. This tool was used to evaluate 3 groups of surgeons: novices, intermediates, and experts. Participants were assessed by 3 independent raters using the KUDAS-TAPP. Inter-rater reliability was analyzed using the intraclass correlation coefficient (ICC), and construct validity was examined by comparing scores across experience levels. RESULTS: A total of 21 participants (5 novices, 10 intermediates, and 6 experts) from 11 institutions were included. The inter-rater reliability of KUDAS-TAPP was high (ICC = 0.91, 95% confidence interval (CI) : 0.84 - 0.96), and internal consistency was excellent (Cronbach's alpha = 0.97). The median KUDAS-TAPP scores differed significantly across experience levels (p < 0.01), with significant differences between novices and experts, and intermediates and experts (p < 0.01). KUDAS-TAPP scores correlated strongly with the number of TAPP procedures performed (ρ = 0.73, p < 0.01), as well as with Global Operative Assessment of Laparoscopic Skills for Groin Hernia (GOALS-GH) (ρ = 0.88, p < 0.01) and TAPP checklist scores (ρ = 0.80, p < 0.01). CONCLUSION: The KUDAS-TAPP is a reliable and valid assessment tool for evaluating situational awareness and decision-making in the TAPP procedure. Its application could enhance surgical education and training by providing a structured framework for assessing and improving nontechnical skills. Future research should explore its effectiveness in training programs and adaptability to other surgical procedures.
• Correction: A nationwide questionnaire survey to investigate facility‑based disparities in satisfaction and working conditions of surgical trainees in Japan: university hospitals, community hospitals, and hybrid‑type facilities.
  Daisuke Koike; Kosei Takagi; Keisuke Arai; Yoshiyuki Kiyasu; Takashi Kohmura; Chiaki Suda; Shinkichi Takamori; Wataru Takayama; Mai Nakamura; Masayuki Fukumoto; Yoshiko Yamaoka-Fujikawa; Genki Watanabe; Jun Watanabe; Saseem Poudel; Norihiko Ikeda; Akinobu Taketomi; Mitsue Saito
  Surgery today, 2025年11月14日, ［国内誌］
  英語
• Minimally invasive abdominal and left thoracic approach (MALTA) for Siewert type II esophagogastric junction adenocarcinoma: A retrospective cohort study of perioperative and oncologic outcomes.
  Takeo Nitta; Yuma Ebihara; Ryo Takagi; Hironobu Takano; Saseem Poudel; Hideyuki Wada; Toshiaki Shichinohe; Satoshi Hirano
  Surgical endoscopy, 2025年10月29日, ［国際誌］
  英語, 研究論文（学術雑誌）, BACKGROUND: The optimal surgical approach for Siewert type II adenocarcinoma of the esophagogastric junction (AEG) remains controversial because of the complex lymphatic spread and anatomical constraints. We previously developed a novel minimally invasive abdominal and left thoracic approach (MALTA) to overcome the limitations of conventional techniques. This study aimed to provide an updated analysis of MALTA with extended follow-up period compared with our initial report. METHOD: A retrospective review was conducted on 16 consecutive patients who underwent MALTA for Siewert type II AEG between 2013 and 2023. The procedure combined laparoscopic gastrectomy and thoracoscopic lower mediastinal esophagectomy with intrathoracic reconstruction, both of which were performed without intraoperative repositioning. Perioperative outcomes, postoperative complications, and survival rates were analyzed. The Kaplan-Meier method was used to estimate overall survival (OS) and disease-free survival (DFS). The primary outcome was feasibility and safety (R0 resection rate and postoperative complications). Secondary outcomes included OS and DFS. RESULTS: R0 resection was achieved in all patients. The median operative time was 438 min, and median blood loss was 28 mL. Postoperative complications occurred in 31.3% of the patients, including anastomotic leakage (12.5%) and empyema (18.8%). No in-hospital deaths or respiratory complications were reported. The median follow-up duration was 51 months. The 1-, 3-, and 5-year OS rates were 87.5% (95% confidence interval [CI], 61.4-96.9), 67.7% (95% CI, 41.8-85.9), and 60.2% (95% CI, 34.7-81.1), respectively. The DFS rates were 68.8% (95% CI, 43.3-86.4), 56.3% (95% CI, 32.4-77.5), and 42.9% (95% CI, 21.5-67.3), respectively. CONCLUSIONS: MALTA appears to be a feasible, safe, and minimally invasive option for Siewert type II AEG, enabling stable intrathoracic anastomosis without patient repositioning. These results suggest its potential utility in achieving favorable perioperative and survival outcomes.
• Challenges faced by novice surgeons in preoperative preparation for emergency surgery: a qualitative study
  Keita Ishido; Mikio Hayashi; Saseem Poudel; Kotoe Kiriyama; Yo Kurashima; Satoshi Hirano
  Global Surgical Education - Journal of the Association for Surgical Education, 4, 1, Springer Science and Business Media LLC, 2025年08月16日
  研究論文（学術雑誌）
• Cultural and Organizational Resistance to Surgical Education Reform: A Narrative Review.
  Keita Ishido; Saseem Poudel; Satoshi Hirano
  Journal of surgical education, 82, 9, 103587, 103587, 2025年06月27日, ［国際誌］
  英語, 研究論文（学術雑誌）, OBJECTIVE: A global transformation in surgical education is occurring toward competency-based frameworks, structured feedback systems, and faculty development initiatives. However, in hierarchical and culturally conservative environments, reforms often meet subtle yet persistent resistance. This review explored how cultural norms, institutional misalignment, and professional risks contribute to the failure or superficial adoption of educational reforms, with particular attention to Japan as a representative example of culturally conservative systems. DESIGN AND SETTING: A narrative review was conducted. PubMed, Scopus, and Web of Science were searched and appropriate literature published between 2000 and 2024 was identified. Keywords included "surgical education," "competency-based medical education," "evaluation systems," "feedback resistance," "organizational culture," and "faculty development." Studies were selected based on relevance to educational reform, resistance dynamics, and educator experiences. Five thematic categories were synthesized, including global trends, sources of resistance, cultural challenges, impacts on educators, and adaptive strategies. RESULTS: We identified layered barriers to reform, including institutional inertia, cultural aversion to feedback, and lack of faculty development infrastructure. In Japan and similar contexts, reforms often failed to gain traction due to social norms that discouraged critique and hierarchical constraints that silenced early-career educators. These conditions led to emotional burdens, burnout, and disengagement. However, examples of adaptive strategies, such as peer-led feedback framed as team development, or simulation-based training aligned with institutional goals, offered pathways for sustainable change. CONCLUSIONS: Educational reform in surgical training must address not only structural implementation but also cultural adaptation. Without psychological safety, institutional endorsement, and context-sensitive design, reforms risk remaining symbolic or being abandoned. This review underscores the need for future research and creation of policy that centers the lived experience of educators and promotes reform ecosystems that are both evidence-based and culturally competent.
• A nationwide questionnaire survey to investigate facility-based disparities in satisfaction and working conditions of surgical trainees in Japan: university hospitals, community hospitals, and hybrid-type facilities.
  Daisuke Koike; Kosei Takagi; Keisuke Arai; Yoshiyuki Kiyasu; Takashi Kohmura; Chiaki Suda; Shinkichi Takamori; Wataru Takayama; Mai Nakamura; Masayuki Fukumoto; Yoshiko Yamaoka-Fujikawa; Genki Watanabe; Jun Watanabe; Saseem Poudel; Mitsue Saito
  Surgery today, 55, 11, 1701, 1709, 2025年06月26日, ［国内誌］
  英語, 研究論文（学術雑誌）, PURPOSE: To investigate disparities and problems within surgical training programs in Japan based on the type of host facility. METHODS: A post hoc analysis of a nationwide questionnaire survey was performed to evaluate program outcomes and working conditions among university hospitals (Group U), a combination of university and community hospitals (Group UC), and community hospitals (Group C). RESULTS: A total of 758 respondents were analyzed across Groups U (n = 199), UC (n = 299), and C (n = 260). Groups U and UC had lower satisfaction scores and smaller surgical volumes than Group C. Academic activity and nonsurgical training in Group U were not superior to those in the other groups. Although overtime work did not differ significantly among groups, poorer working conditions, including a lower rate of overtime allowance, more frequent night duties, and a lower annual income, were found in Group U than in the other groups. CONCLUSION: This study revealed disparities and problems in training programs based on the type of host facility. Further improvements in working conditions and educational contexts are expected to help increase satisfaction levels and recruitment of surgical residents in the future.
• Successful Introduction of a New Pediatric Endoscopic Procedure in Nepal by Simulation-Based Training Using a Disease-Specific Simulator.
  Masakazu Murakami; Saseem Poudel; Jasmine Bajracharya; Shinichiro Yokoyama; Rameshwar Prasad Pokharel; Ramnandan P Chaudhary; Satoshi Ieiri
  World journal of surgery, 49, 7, 1862, 1869, 2025年06月16日, ［国際誌］
  英語, 研究論文（学術雑誌）, BACKGROUND: Endosurgery has several advantages over open surgery in the context of global surgery. Simulation-based training (SBT) is a highly effective educational modality for pediatric endoscopic surgery. This study assessed the effectiveness of SBT using a disease-specific simulator for laparoscopic percutaneous extraperitoneal closure (LPEC) in low- and middle-income countries (LMICs). METHODS: We developed a disease-specific simulator for LPEC surgery that reproduces an infant's small pelvic cavity and lower abdomen. We held a workshop for LPEC surgery in Kathmandu, Nepal. The workshop consisted of lectures, hands-on training using the LPEC simulator, and live surgery for LPEC. To assess the effectiveness of the workshop, skill evaluation tests were conducted before and after the workshop. In addition, a follow-up survey was conducted 8 months after the workshop to investigate whether or not LPEC surgery was implemented. RESULTS: Twenty-three participants completed the workshops. The skill evaluation tests using the LPEC simulator revealed that participants' skills had improved significantly after the workshop with regard to task completion time (650.4 ± 363.4 vs. 389.0 ± 179.1 s, p < 0.01). In live surgery, the first LPEC surgery in Nepal was successfully performed by a local pediatric surgeon without intraoperative complications. Five institutions out of 6 responded to the follow-up questionnaire survey (response rate: 83.3%). LPEC surgery was implemented in 4 out of 6 institutions (66.7%). In the 8 months following the workshop, a total of 725 surgeries for pediatric inguinal hernia were performed at 5 hospitals, of which 68 (9.4%) were LPEC surgeries. There were no intraoperative complications or recurrences during these 68 LPEC surgeries. CONCLUSIONS: SBT using a disease-specific simulator is effective for safe introduction of new pediatric endoscopic surgical procedures in LMICs.
• How confident are the general surgeons in Hokkaido region in performing essential trauma skills: a cross-sectional questionnaire survey.
  Kazuyuki Hirose; Saseem Poudel; Soichi Murakami; Yo Kurashima; Nagato Sato; Hiroyasu Tojima; Isao Yokota; Kazufumi Okada; Toshiaki Shichinohe; Satoshi Hirano
  World journal of emergency surgery : WJES, 20, 1, 49, 49, 2025年06月05日, ［国際誌］
  英語, 研究論文（学術雑誌）, BACKGROUND: In Japan-particularly in the Hokkaido region-a limited number of dedicated trauma surgeons often compels general surgeons to serve as frontline providers of trauma care. However, their ability to perform critical trauma procedures and their level of confidence remain unclear. Understanding this gap is vital for guiding targeted training programs aimed at improving patient outcomes. Although conducted in one region, these findings may inform strategies in other remote or resource-limited settings worldwide, where timely surgical intervention significantly affects survival. Therefore, the objective of this study was to evaluate the experience and confidence of general surgeons in Hokkaido in performing 35 essential trauma procedures. METHODS: This prospective observational study surveyed all general surgeons and surgical residents working in hospitals that regularly perform surgical procedures in Hokkaido. Participants provided demographic information, trauma training history, and self-assessed confidence and experience in performing 35 procedures identified via a previous Delphi study. Confidence was defined as a Likert scale rating of 4 or 5. Comparisons were made between respondents with and without advanced trauma training (e.g., ATOM, DSTC) and between those who had managed more than 50 trauma cases versus fewer than 50. RESULTS: Of 730 eligible participants, 444 completed the survey (62.2%). Over half (57.9%) reported fewer than 10 lifetime trauma surgeries, and 64.4% had not managed a trauma case in the past year. Only six procedures were rated confidently (≥ 4) by more than half the respondents, including endotracheal intubation, chest tube placement, and selected gastrointestinal procedures. Subgroup analyses indicated that surgeons generally had higher confidence in procedures related to their subspecialty, whereas less frequent or advanced trauma skills remained areas of concern. Surgeons with advanced trauma training or a higher trauma case volume (> 50) demonstrated significantly greater confidence in multiple trauma-specific skills. CONCLUSION: General surgeons in Hokkaido lack confidence in most essential trauma procedures, particularly those encountered infrequently. Although these findings originate from one region, they underscore training gaps potentially relevant to other remote or resource-limited areas, where frontline trauma care demands targeted, high-yield interventions to improve outcomes.
• Implementation of the GLIM (Global Leadership Initiative on Malnutrition) Criteria in Gastrointestinal Oncology: A Narrative Review of Systemic Impact and the Role of Dietitians.
  Keita Ishido; Mio Nakashima; Saseem Poudel; Zen Naito; Akitaka Motoyoshi; Kaito Sano; Satoshi Hirano
  Cureus, 17, 6, e86826, 2025年06月, ［国際誌］
  英語, 研究論文（学術雑誌）, Malnutrition is a common yet frequently underrecognized condition among patients with gastrointestinal cancers, significantly impacting treatment tolerance, postoperative recovery, and long-term outcomes. This narrative review explores the clinical implementation of the Global Leadership Initiative on Malnutrition (GLIM) criteria in gastrointestinal oncology, with a particular focus on its impact on multidisciplinary workflows and the evolving role of clinical dietitians. A structured literature search was conducted using PubMed to identify English-language publications from 2018 to 2025 that included the terms "GLIM," "malnutrition," "gastrointestinal cancer," "nutritional assessment," and "oncology." Fifty-three articles were selected for inclusion based on their relevance to GLIM criteria implementation and interdisciplinary care models in oncologic settings. In clinical practice, the GLIM framework has elevated nutrition care from an ancillary task to a core component of oncology management. The adoption of GLIM criteria encourages interprofessional collaboration, involving surgeons, oncologists, nurses, and dietitians. It also necessitates the use of tools such as bioelectrical impedance analysis and computed tomography to assess muscle mass, as well as laboratory markers of inflammation, further reinforcing the technical competencies required of dietitians. However, barriers remain. Implementation is hindered by limited training, workflow inconsistencies, time constraints, and disparities in access to diagnostic tools, particularly in resource-limited settings. Additionally, institutional variability and lack of integration into reimbursement systems pose systemic challenges. To support sustainable adoption, many institutions have established structured referral pathways, interdisciplinary training initiatives, and electronic health record algorithms for GLIM-based assessment. These efforts are crucial for overcoming barriers and standardizing care. Furthermore, GLIM-based protocols have improved patient engagement and empowered patients to participate more actively in their nutritional care, especially through the use of standardized tools like the Patient-Generated Subjective Global Assessment. Looking forward, further research is needed to validate simplified diagnostic methods, improve equity in access, and assess long-term impacts on survival and quality of life. Policy reforms, including the recognition of GLIM-based malnutrition in coding systems, could enhance institutional incentives for implementation. Ultimately, the GLIM criteria provide not only a diagnostic tool but also a foundational framework for advancing equitable, interdisciplinary, and patient-centered nutrition care in oncology.
• Differences in Preoperative Preparation Between Novice Surgeons and Experts: A Scoping Review.
  Keita Ishido; Kotoe Kiriyama; Saseem Poudel; Makiko Hiradate; Yukari Kono; Yo Kurashima; Satoshi Hirano
  Journal of surgical education, 82, 7, 103540, 103540, 2025年05月15日, ［国際誌］
  英語, 研究論文（学術雑誌）, BACKGROUND: Patient outcomes are strongly influenced by the experience of the surgeon. Expert surgeons typically exhibit broader situational awareness and risk assessment, whereas novice surgeons tend to have more focused planning and a higher cognitive load under stressful conditions. This scoping review aimed to clarify the differences in preoperative preparation between novice and expert surgeons. By mapping existing studies, we highlighted critical gaps and proposed directions for research in surgical education. METHODS: Following the PRISMA-ScR guidelines, we searched the PubMed and Cochrane Library databases for English-language articles published through October 2024. The search terms were: "expert," "novice," "preoperative," and "decision-making and preparation", although these were supplemented by hand-searching reference lists. Ten studies comparing the preoperative communication, treatment planning, and decision-making of novice and expert surgeons were included. RESULTS: Our data indicated that expert surgeons demonstrated more proactive communication, broader situational awareness, and stronger checklist adherence than novice surgeons. Nontechnical skills generally improved with experience, although there was evidence of a plateau at advanced stages. Three studies reported a higher preoperative planning accuracy among experts, whereas 1 study showed no significant differences. Novice surgeons tended to focus on immediate tasks, while experts considered long-term risks and management strategies. Reflective learning, mentorship, and simulation-based practice were frequently emphasized as the keys to bridging this gap in knowledge, highlighting the multifaceted nature of surgical expertise. CONCLUSION: Preoperative preparation differs between novice and expert surgeons. This observation supports the need for structured mentorship and targeted training to accelerate skills development. Such interventions may improve patient safety and outcomes, particularly in high-stress settings. Further research should clarify how these strategies influence long-term outcomes under high-stress conditions.
• A standardized protocol for robot-assisted minimally invasive esophagectomy: improving efficiency and reducing costs.
  Hidehiko Kitagami; Saseem Poudel; Yosuke Kitayama; Junkichi Koinuma; Yuma Ebihara; Satoshi Hirano
  Journal of robotic surgery, 19, 1, 107, 107, 2025年03月10日, ［国際誌］
  英語, 研究論文（学術雑誌）, Robot-assisted minimally invasive esophagectomy (RAMIE) has shown potential benefits over conventional procedures for esophageal cancer. However, uniform surgical protocols are lacking, leading to variability in outcomes and increased costs. This retrospective study included 180 patients with esophageal cancer who underwent RAMIE between May 2018 and September 2024. A standardized approach, termed counterclockwise partitioned mediastinal dissection (CPMD), was introduced in 114 of these cases. Perioperative parameters including operative time, blood loss, complications, and cost of disposable instruments, were compared between patients treated before and after protocol standardization. Among the 114 patients who received the standardized RAMIE protocol, the median thoracic console time significantly decreased to 148 min, with overall blood loss reduced to 62 ml. No conversions to open surgery were required in either cohort. Compared to the pre-standardization group, postoperative complications-including recurrent laryngeal nerve paralysis-were lower and only one patient needed reoperation. Importantly, reusing robotic instruments from the thoracic phase in the abdominal phase reduced disposable instrument costs, resulting in a savings of approximately 168,000 Japanese Yen (USD 1050) per case. Implementing a standardized RAMIE protocol enhances procedural efficiency, reduces blood loss, and lowers costs without compromising surgical or oncological outcomes. This approach may facilitate broader adoption of RAMIE as a safe and cost-effective strategy for esophageal cancer surgery.
• Regional disparity in surgical residency training and work environment between urban and regional hospitals: an additional perspective from a nationwide survey of surgical residents.
  Genki Watanabe; Jun Watanabe; Saki Hayashi; Takaaki Konishi; Saseem Poudel; Yoshiyuki Kiyasu; Masayuki Fukumoto; Takahiro Korai; Shinsuke Nomura; Naohiro Yamamoto; Masao Nakajima; Keiko Hosoya; Mitsue Saito
  Surgery today, 55, 8, 1143, 1154, 2025年02月11日, ［国内誌］
  英語, 研究論文（学術雑誌）, PURPOSE: To investigate the current status of regional disparities in surgical residency training between urban and regional hospitals. METHODS: Based on a nationwide online questionnaire survey of newly certified surgical trainees, the responding residents were divided into the following two groups according to the size of the city in which they had trained: the urban city group (UC group; population > 1 million) and the regional city group (RC group; population < 1 million. Surgical education and work environment of the two groups were compared. RESULTS: The UC group (n = 317, 42%) was characterized by greater post-graduate experience, older age, a higher proportion of female surgeons, and a higher percentage of full-time working partners relative to the RC group (n = 439, 58%). More residents in the UC group were from urban areas, whereas the RC group had more residents from regional areas. No differences were observed in the number of surgeries performed, published papers, opportunities for off-the-job training, or satisfaction with the surgical residency training program. With the exception of higher income in the RC group, no differences were observed for other factors related to the work environment. CONCLUSIONS: There was little regional disparity regarding the impressions of surgical residency training between urban and regional cities, including surgical education and work environment.
• Evaluating the role and future direction of the Japanese association for surgical education: a needs assessment survey among participants in the annual meetings
  Masayuki Fukumoto; Saseem Poudel; Junko Tokuno; Shinichiro Kobayashi; Susumu Eguchi; Yo Kurashima
  Global Surgical Education - Journal of the Association for Surgical Education, 4, 1, Springer Science and Business Media LLC, 2025年01月31日
  研究論文（学術雑誌）
• Enhancing surgical skills through telesimulation: A multicenter randomized controlled trial on laparoscopic inguinal hernia repair.
  Kotoe Kiriyama; Yo Kurashima; Saseem Poudel; Yusuke Watanabe; Yoichi M Ito; Satoshi Hirano
  Surgery, 180, 109136, 109136, 2025年01月21日, ［国際誌］
  英語, 研究論文（学術雑誌）, BACKGROUND: Telesimulation has been shown to be effective for teaching simple surgical techniques; however, its usefulness for teaching advanced skills remains unclear. The aim of this randomized controlled trial was to investigate the impact of a telesimulation program on training for laparoscopic inguinal hernia repair. METHODS: Novice trainees were randomly assigned to the intervention group or control group using a permuted block design. Intervention group participants received a 1-hour didactic telelecture and three 1-hour telesimulation sessions with a hernia specialist, whereas control group participants engaged in self-directed training using the same simulator and materials. Trainees' procedural videos, recorded before and after training, were assessed using the transabdominal preperitoneal checklist and the Global Operative Assessment of Laparoscopic Skills-Groin Hernia. Pre- and post-training tests were performed to evaluate knowledge of inguinal hernias and self-confidence in transabdominal preperitoneal procedures. RESULTS: Forty-three participants from 16 institutions in Japan were enrolled, with 22 and 19 in the intervention group and control group, respectively, completing the final analysis. Median post-test transabdominal preperitoneal checklist scores were 16 (interquartile range: 15-18.5) in the intervention group and 11 (interquartile range: 8.5-14.5) in the control group; intervention group participants significantly outperformed their counterparts (P < .001). However, comparison of pre- and post-test scores showed skill improvements in both groups (P < .001). Both groups also showed increased knowledge and confidence. CONCLUSION: The telesimulation program effectively enhanced the surgical skills of novice trainees in learning laparoscopic inguinal hernia repair, demonstrating superiority over self-directed learning.
• Patient-reported short-term results of laparoscopic groin hernia repair: A multicenter prospective observational study from Japan
  Saseem Poudel; Yoshihiro Ikeda; Tatsuya Tazaki; Seiya Susumu; Toshikatsu Nitta; Shinichi Yoshioka; Masaki Wakasugi; Masaru Matsumura; Tadashi Ohnishi; Kaisuke Yamamoto; Satoshi Hirano
  INTERNATIONAL JOURNAL OF ABDOMINAL WALL AND HERNIA SURGERY, 8, 1, 13, 20, 2025年01月
  英語, 研究論文（学術雑誌）
• What do surgical trainees and educators around the world need: a global needs assessment survey from 6 regions around the world
  Saseem Poudel; Yo Kurashima; Panagiotis Kapsampelis; Georgios Tsoulfas; Bianca Calsolari; Ramiro Colleoni; Adewale Adisa; Anip Joshi; Leizl Joy Nayahangan; Lars Konge; Sarkis H. Meterissian; Julian Varas; Tao Xiao; Kemal Rasa; Dimitrios Stefanidis
  Global Surgical Education - Journal of the Association for Surgical Education, 4, 1, Springer Science and Business Media LLC, 2024年12月23日
  研究論文（学術雑誌）
• State of groin hernia repair in Japan: Annual Report of 2022 from the National Clinical Database.
  Saseem Poudel; Hiroyuki Yamamoto; Kyosuke Miyazaki; Hitoshi Idani; Masanori Sato; Tsuyoshi Takagi; Itsuro Nagae; Taketo Matsubara; Ken Shirabe; Hideki Ueno; Takehiro Hachisuka
  Surgery today, 55, 7, 953, 959, 2024年12月02日, ［国内誌］
  英語, 研究論文（学術雑誌）, PURPOSE: The National Clinical Database (NCD) in Japan captures over 95% of the surgeries performed by general surgeons. In May 2021, the Japan Hernia Society (JHS) introduced additional categories for groin hernia repair at JHS-registered institutions. This study presents the 2022 data on groin hernia repair from the NCD. METHODS: This study included all cases of groin hernia repair registered in the NCD for 2022. The basic data collected included age, sex, type of surgery, day surgery status, emergency status, and anesthesia involvement. For JHS-registered institutions, data on hernia laterality, whether the case was primary or recurrent, surgical details, and groin hernia classifications were also collected. RESULTS: Of the 908 institutions reporting to the NCD, 459 (50.6%) were JHS registered. A total of 118,365 groin hernia repairs were recorded, of which 43,952 (37.1%) were from JHS-registered institutions. Endoscopic repair accounted for 53.3% (n = 63,208) of the patients. Day surgery was performed in 5.1% (n = 6045) of the patients. At JHS-registered institutions, 81.6% of bilateral hernias were treated by endoscopic repair; 68.1% were lateral hernias. The most commonly used method was the TAPP method, which was applied in 48.8% of cases. CONCLUSIONS: Although endoscopic repair is widely used in Japan, day surgery rates remain low. Improving data collection and increasing NCD participation are crucial for aligning with international standards.
• Current status of the surgical training system in Japan: results of a nationwide questionnaire survey of graduating surgical trainees.
  Yoshiyuki Kiyasu; Saseem Poudel; Daisuke Koike; Jun Watanabe; Ryosuke Kowatari; Masayuki Fukumoto; Yoshiko Yamaoka-Fujikawa; Yuta Kikuchi; Keisuke Arai; Eisuke Booka; Sonoko Ishida; Shinichiro Yokoyama; Mitsue Saito
  Surgery today, 55, 1, 90, 98, 2024年06月26日, ［国内誌］
  英語, 研究論文（学術雑誌）, PURPOSE: To identify the problems trainees face during surgical training in Japan. METHODS: A nationwide online questionnaire survey was conducted targeting newly certified surgical trainees. RESULTS: The response rate was 53.8% (758/1410). Among those respondents, 25.6% were women, 71.4% were either married or had a partner, 41.3% had children, 72.7% had performed over 200 surgeries under general anesthesia, and 54.1% had chosen, before graduating from medical school, to become a surgeon. While 88.8% were interested in learning surgical techniques, 63.8% were hesitant to become a surgeon for fear of a compromised quality of private life (QOL). Conversely, only 1.4% chose their surgical training programs based on QOL. Overall, 84.6% of the trainees were satisfied with their training and this correlated with the number of surgeries performed. Only 29.9% received non-technical skill training. The average number of night shifts per month was 5.6, and 10.6% worked over 80 h per week. Harassment was reported by 41.5% of the respondents. Moreover, 33.0% had considered dropping out at some time, primarily because of their QOL (51.1%) or the harassment they had encountered (50.4%). CONCLUSION: This survey revealed that while trainees were satisfied with the overall training system, issues such as long working hours and harassment are prevalent. Working to improve these issues could make surgery more attractive for young trainees.
• Global Surgeryとしてのネパール小児内視鏡外科手術の導入支援
  村上 雅一; サシーム・パウデル; 横山 新一郎; 家入 里志
  日本小児外科学会雑誌, 60, 3, 495, 495, (一社)日本小児外科学会, 2024年04月
  日本語
• Development of a simulator and training curriculum for liver trauma surgery training for general surgeons
  Hiroyasu Tojima; Soichi Murakami; Saseem Poudel; Yo Kurashima; Toshimichi Asano; Takehiro Noji; Kazufumi Okada; Yoichi M. Ito; Hiroyuki Kaneko; Yoshimitsu Izawa; Hiroshi Homma; Satoshi Hirano
  Global Surgical Education - Journal of the Association for Surgical Education, 3, 1, Springer Science and Business Media LLC, 2024年03月17日
  研究論文（学術雑誌）
• 鼠径ヘルニア手術治療の変遷から得た外科医教育-総括と展望- オンラインプラットフォームおよびテクノロジーを駆使した腹腔鏡下鼠径ヘルニア修復術教育手法の変遷
  倉島 庸; サシーム・パウデル; 海老原 裕磨; 村上 壮一; 七戸 俊明; 平野 聡; 早川 哲史
  日本内視鏡外科学会雑誌, 28, 7, 2330, 2330, (一社)日本内視鏡外科学会, 2023年12月
  日本語
• LPECシミュレータ開発・検証とGlobal Surgeryとしてのネパールでの小児内視鏡外科手術の導入支援
  村上 雅一; Poudel Saseem; 横山 新一郎; 家入 里志
  日本内視鏡外科学会雑誌, 28, 7, 1505, 1505, (一社)日本内視鏡外科学会, 2023年12月
  日本語
• Delphi Method Consensus-Based Identification of Primary Trauma Care Skills Required for General Surgeons in Japan
  Kazuyuki Hirose; Soichi Murakami; Yo Kurashima; Nagato Sato; Saseem Poudel; Kimitaka Tanaka; Aya Matsui; Yoshitsugu Nakanishi; Toshimichi Asano; Takehiro Noji; Yuma Ebihara; Toru Nakamura; Takahiro Tsuchikawa; Toshiaki Shichinohe; Kazufumi Okada; Isao Yokota; Naoto Hasegawa; Satoshi Hirano
  Journal of Acute Care Surgery, 13, 2, 58, 65, Korean Society of Acute Care Surgery, 2023年07月31日
  研究論文（学術雑誌）, Purpose: General surgeons at regional hospitals should have the primary trauma care skills necessary to treat critically ill trauma patients to withstand transfer. This study was conducted to identify a consensus on primary trauma care skills for general surgeons.Methods: An initial list of acute care surgical skills was compiled, and revised by six trauma experts (acute care surgeons); 33 skills were nominated for inclusion in the Delphi consensus survey. Participants (councilors of the Japanese Society for Acute Care Surgery) were presented with the list of 33 trauma care skills and were asked (using web-based software) to rate how strongly they agreed or disagreed (using a 5-point Likert scale) with the necessity of each skill for a general surgeon. The reliability of consensus was predefined as Cronbach’s α ≥ 0.8, and trauma care skills were considered as primarily required when rated 4 (agree) or 5 (strongly agree) by ≥ 80% participants.Results: There were 117 trauma care specialists contacted to participate in the Delphi consensus survey panel. In the 1^st round, 85 specialists participated (response rate: 72.6%). In the 2^nd round, 66 specialists participated (response rate: 77.6%). Consensus was achieved after two rounds, reliability using Cronbach’s α was 0.94, and 34 items were identified as primary trauma care skills needed by general surgeons.Conclusion: A consensus-based list of trauma care skills required by general surgeons was developed. This list can facilitate the development of a new trauma training course which has been optimized for general surgeons.
• The degree of satisfaction and level of learning in male and female surgical residents: a nationwide questionnaire survey of graduating residents in Japan.
  Koya Hida; Satoshi Hirano; Saseem Poudel; Yo Kurashima; Dimitrios Stefanidis; Daisuke Hashimoto; Hirotoshi Akiyama; Susumu Eguchi; Toshihiro Fukui; Masaru Hagiwara; Tomoko Izaki; Shunsuke Kawamoto; Yasuhiro Otomo; Eishi Nagai; Hideki Takami; Yuko Takeda; Masakazu Toi; Hiroki Yamaue; Motofumi Yoshida; Shigetoshi Yoshida; Yasuhiro Kodera; Mitsue Saito
  Surgery today, 53, 11, 1275, 1285, 2023年05月10日, ［国内誌］
  英語, 研究論文（学術雑誌）, PURPOSE: Since 2002, the Japan Surgical Society has established a board certification system for surgeons to be certified for a specialty. Surgery remains a male-dominated field in Japan. This study aimed to clarify if the Japanese surgical residency training system is equally suitable for female and male residents. METHODS: The Japan Surgical Society conducted the first questionnaire survey regarding the system of surgical training for the residents in 2016. The questionnaire included the degree of satisfaction with 7 aspects of the training system, including the number and variety of cases experienced and duration and quality of instruction, and the learning level for 31 procedures. The degree of satisfaction and level of learning were compared between female and male residents. RESULTS: The degree of satisfaction was similar for all items between female and male residents. Female residents chose breast surgery as their subspecialty more frequently than male residents and were more confident in breast surgery procedures than male residents. Conversely, fewer female residents chose gastrointestinal surgery and were less confident in gastrointestinal surgery procedures than male residents. CONCLUSION: Female residents were as satisfied with the current surgical training system as male residents. However, there may be room for improvement in the surgical system, considering that fewer applications for gastrointestinal surgery come from female residents than from males.
• 外科医を目指す若手医師に対する教育の現状と課題 指導医が考える若手外科医教育の世界の現状と我が国の展望 国際サーベイ
  倉島 庸; サシーム・パウデル; 海老原 裕磨; 村上 壮一; 七戸 俊明; 平野 聡
  日本外科系連合学会誌, 48, 3, 331, 331, 日本外科系連合学会, 2023年05月
  日本語
• 大規模国際サーベイから考える世界の中の日本の若手外科医教育の光と影
  倉島 庸; サシーム・パウデル; 海老原 裕磨; 村上 壮一; 七戸 俊明; 平野 聡
  日本外科学会定期学術集会抄録集, 123回, SP, 1, (一社)日本外科学会, 2023年04月
  日本語
• 一般外科医のための腹部外傷手術シミュレーターおよびトレーニングプログラム開発
  東嶋 宏泰; 村上 壮一; 倉島 庸; サシーム・パウデル; 野路 武寛; 金古 裕之; 伊澤 祥光; 本間 宙; 平野 聡
  日本外科学会定期学術集会抄録集, 123回, SP, 6, (一社)日本外科学会, 2023年04月
  日本語
• Surgical skills assessment of pancreaticojejunostomy using a simulator may predict patient outcomes: A multicenter prospective observational study.
  Kenichi Mizunuma; Yo Kurashima; Saseem Poudel; Yusuke Watanabe; Takehiro Noji; Toru Nakamura; Keisuke Okamura; Toshiaki Shichinohe; Satoshi Hirano
  Surgery, 173, 6, 1374, 1380, 2023年03月30日, ［国際誌］
  英語, 研究論文（学術雑誌）, BACKGROUND: Pancreatoduodenectomy, an advanced surgical procedure with a high complication rate, requires surgical skill in performing pancreaticojejunostomy, which correlates with operative outcomes. We aimed to analyze the correlation between pancreaticojejunostomy assessment conducted in a simulator environment and the operating room and patient clinical outcomes. METHODS: We recruited 30 surgeons (with different experience levels in pancreatoduodenectomy) from 11 institutes. Three trained blinded raters assessed the videos of the pancreaticojejunostomy procedure performed in the operating room using a simulator according to an objective structured assessment of technical skill and a newly developed pancreaticojejunostomy assessment scale. The correlations between the assessment score of the pancreaticojejunostomy performed in the operating room and using the simulator and between each assessment score and patient outcomes were calculated. The participants were also surveyed regarding various aspects of the simulator as a training tool. RESULTS: There was no correlation between the average score of the pancreaticojejunostomy performed in the operating room and that in the simulator environment (r = 0.047). Pancreaticojejunostomy scores using the simulator were significantly lower in patients with postoperative pancreatic fistula than in those without postoperative pancreatic fistula (P = .05). Multivariate analysis showed that pancreaticojejunostomy assessment scores were independent factors in postoperative pancreatic fistula (P = .09). The participants highly rated the simulator and considered that it had the potential to be used for training. CONCLUSION: There was no correlation between pancreaticojejunostomy surgical performance in the operating room and the simulation environment. Surgical skills evaluated in the simulation setting could predict patient surgical outcomes.
• 胃癌に対する低侵襲手術のエビデンス 術中パフォーマンス評価のエビデンス 腹腔鏡下胃切除術技能評価と術後成績及び教育的意義に関する検討
  倉島 庸; サシーム・パウデル; 海老原 裕磨; 村上 壮一; 七戸 俊明; 平野 聡
  日本内視鏡外科学会雑誌, 27, 7, 921, 921, (一社)日本内視鏡外科学会, 2022年12月
  日本語
• 内視鏡外科手術における遠隔医療の現状と課題 遠隔シミュレーションで腹腔鏡下鼠径ヘルニア手術はトレーニング可能か?無作為比較試験による教育効果検討
  桐山 琴衣; 倉島 庸; サシーム・パウデル; 渡邊 祐介; 海老原 裕磨; 村上 壮一; 七戸 俊明; 平野 聡
  日本内視鏡外科学会雑誌, 27, 7, 1269, 1269, (一社)日本内視鏡外科学会, 2022年12月
  日本語
• Development of a systematic telesimulation curriculum for laparoscopic inguinal hernia repair
  Kotoe Kiriyama; Saseem Poudel; Yo Kurashima; Yusuke Watanabe; Yoshihiro Murakami; Kyosuke Miyazaki; Yo Kawarada; Satoshi Hirano
  Global Surgical Education - Journal of the Association for Surgical Education, 1, 1, 52, 52, Springer Science and Business Media LLC, 2022年10月20日, ［国際誌］
  英語, 研究論文（学術雑誌）, PURPOSE: Telesimulation, whereby learners telecommunicate and use simulator resources to receive education at an off-site location, has been used to educate surgical trainees about how to perform basic surgical procedures. However, it has not yet been used for advanced surgical procedures. We aimed to develop a telesimulation curriculum to teach a common laparoscopic procedure called transabdominal preperitoneal (TAPP) repair and to explore the feasibility of its use. METHODS: Learning objectives were created to develop a telesimulation curriculum that included didactic telelecture and telesimulation training. Pre-tests and post-tests to assess the didactic materials were developed and assessed among surgeons with various experiences. We assessed the feasibility of the telelecture and telesimulation separately. Pre-tests, post-tests, and questionnaires were used to assess the telelectures. We created a TAPP repair telesimulation system and checked for problems during training. Trainees were assessed to determine their skill improvement using previously published assessment tools and questionnaires. RESULTS: A didactic telelecture was developed based on the learning objectives using an expert consensus and pilot-tested among five participants. After the lecture, their test scores improved and they expressed positive opinions about the usefulness of telelectures. The TAPP repair telesimulation training was pilot-tested among three trainees. No technical problems occurred during training. All trainees improved their skills after the telesimulation training and agreed that the training was useful for learning the TAPP repair procedure. CONCLUSIONS: We systematically developed a telesimulation curriculum for the TAPP repair procedure and demonstrated its feasibility among learners.
• 【総論】各臓器サブサブスペシャルティ外科医の育成法 言語化された技能評価と重要局面にポイントを置いた腹腔鏡下胃切除術教育法
  倉島 庸; サシーム・パウデル; 海老原 裕磨; 村上 壮一; 七戸 俊明; 平野 聡
  日本消化器外科学会総会, 77回, WS15, 5, (一社)日本消化器外科学会, 2022年07月
  日本語
• 【総論】各臓器サブサブスペシャルティ外科医の育成法 言語化された技能評価と重要局面にポイントを置いた腹腔鏡下胃切除術教育法
  倉島 庸; サシーム・パウデル; 海老原 裕磨; 村上 壮一; 七戸 俊明; 平野 聡
  日本消化器外科学会総会, 77回, WS15, 5, (一社)日本消化器外科学会, 2022年07月
  日本語
• Validation study of a skill assessment tool for education and outcome prediction of laparoscopic distal gastrectomy.
  Yo Kurashima; Hidehiko Kitagami; Koichi Teramura; Saseem Poudel; Yuma Ebihara; Noriyuki Inaki; Fumitaka Nakamura; Kazunari Misawa; Kazunori Shibao; Eishi Nagai; Yoshimasa Akashi; Shuji Takiguchi; Shinichiro Kobayashi; Satoshi Hirano
  Surgical endoscopy, 36, 12, 8807, 8816, 2022年05月16日, ［国際誌］
  英語, 研究論文（学術雑誌）, BACKGROUND: The Japanese operative-rating scale for laparoscopic distal gastrectomy (JORS-LDG) was developed through cognitive task analysis together with the Delphi method to measure intraoperative performance during laparoscopic distal gastrectomy. This study aimed to investigate the value of this rating scale as an educational tool and a surgical outcome predictor in laparoscopic distal gastrectomy. METHODS: The surgical performance of laparoscopic distal gastrectomy was assessed by the first assistant, through self-evaluation in the operating room and by video raters blind to the case. We evaluated inter-rater reliability, internal consistency, and correlations between the JORS-LDG scores and the evaluation methods, patient characteristics, and surgical outcomes. RESULTS: Fifty-four laparoscopic distal gastrectomy procedures performed by 40 surgeons at 16 institutions were evaluated in the operating room and with video recordings using the proposed rating scale. The video inter-rater reliability was > 0.8. Participating surgeons were divided into the low, intermediate, and high groups based on their total scores. The number of laparoscopic surgeries and laparoscopic gastrectomy procedures performed differed significantly among the groups according to laparoscopic distal gastrectomy skill levels. The low, intermediate, and high groups also differed in terms of median operating times (311, 266, and 229 min, respectively, P < 0.001), intraoperative complication rates (27.8, 11.8, and 0%, respectively, P = 0.01), and postoperative complication rates (22.2, 0, and 0%, respectively, P = 0.002). CONCLUSIONS: The JORS-LDG is a reliable and valid measure for laparoscopic distal gastrectomy training and could be useful in predicting surgical outcomes.
• Establishing the Japanese Association for Surgical Education: our experience of promoting systematic surgical education in Japan
  Saseem Poudel; Yo Kurashima; Satoshi Hirano
  Global Surgical Education - Journal of the Association for Surgical Education, 1, 1, Springer Science and Business Media LLC, 2022年04月12日
  研究論文（学術雑誌）
• It is not acceptable to injure external iliac vessels during a laparoscopic inguinal hernia procedure even if you have the skills to repair it laparoscopically.
  Saseem Poudel; Tatsuya Tazaki
  Asian journal of endoscopic surgery, 15, 2, 476, 477, 2022年04月, ［国内誌］
  英語
• 膵空腸吻合における技能の評価ツールおよびシミュレーションモデルの開発
  水沼 謙一; 倉島 庸; サシーム・パウデル; 渡邊 祐介; 田中 公貴; 中西 善嗣; 浅野 賢道; 野路 武寛; 海老原 裕磨; 村上 壮一; 中村 透; 土川 貴裕; 七戸 俊明; 平野 聡
  日本臨床外科学会雑誌, 83, 3, 599, 599, 日本臨床外科学会, 2022年03月
  日本語
• 地域基幹病院における高難度鏡視下手術の安全な実践と後進への教育について 科学的プロセスに基づいた内視鏡外科手術技能評価による教育・アウトカム予測の意義
  倉島 庸; サシーム・パウデル; 海老原 裕磨; 村上 壮一; 七戸 俊明; 平野 聡
  日本内視鏡外科学会雑誌, 26, 7, CSY11, 1, (一社)日本内視鏡外科学会, 2021年12月
  日本語
• Laparoscopic approach as a safe and effective option for incarcerated femoral hernias.
  Ryo Okazaki; Saseem Poudel; Yuma Hane; Takahiro Saito; Jun Muto; Yasuhito Syoji; Ryunosuke Hase; Naoto Senmaru; Satoshi Hirano
  Asian journal of endoscopic surgery, 15, 2, 328, 334, 2021年11月08日, ［国内誌］
  英語, 研究論文（学術雑誌）, INTRODUCTION: The laparoscopic approach for elective femoral herniorrhaphy is well established. However, femoral hernias often present as incarcerations and require emergency repair surgery, mainly using the open approach. This study aimed to retrospectively analyze the efficacy of the laparoscopic approach for incarcerated femoral hernias. METHODS: Data of patients who underwent emergency surgery for incarcerated femoral hernia between April 2016 and August 2021 were retrospectively analyzed. Laparoscopy was performed whenever possible; however, conversion to an open approach remained a fallback option for when laparoscopic repair was not possible. In laparoscopic repair, incarcerated femoral hernias reduced using traction, water pressure, and preperitoneal methods. Data of patients who underwent open repair and laparoscopy were then compared. RESULTS: During the observation period, 20 patients underwent emergency surgery for incarcerated femoral hernia. Eleven patients subsequently underwent repair using a laparoscopic approach, and eight underwent repair using an open approach. Only one patient underwent intestinal resection without hernia repair due to perforated bowel. Operative time for laparoscopic repair was longer. Mesh repair was performed in 18 patients. Four patients each in the laparoscopic repair and open group required intestinal resection. CONCLUSION: Incarcerated femoral hernias can be safely repaired using the laparoscopic approach.
• Support for Introduction of Pediatric Endosurgery in Nepal as Global Pediatric Surgery: Preliminary Needs Assessment Survey.
  Masakazu Murakami; Saseem Poudel; Jasmine Bajracharya; Masahiro Fukuhara; Kotoe Kiriyama; Manish Raj Shrestha; Ramnandan P Chaudhary; Rameshwar Prasad Pokharel; Yo Kurashima; Satoshi Ieiri
  Journal of laparoendoscopic & advanced surgical techniques. Part A, 31, 12, 1357, 1362, 2021年10月05日, ［国際誌］
  英語, 研究論文（学術雑誌）, Background: Endosurgery provides several advantages over open surgery in the context of global surgery; however, there are several barriers to its introduction. The preliminary assessment of needs and barriers is essential for carrying out effective support as Global Surgery. However, no report has described the initiation of support for endosurgery based on a preliminary survey of the needs and barriers. The present survey study aimed at determining the needs and barriers of pediatric endosurgery in Nepal. Materials and Methods: A needs assessment survey was conducted among all pediatric surgeons in Nepal via an online platform. This was followed by workshop on pediatric endosurgical skills in Nepal. To assess the skills of participants and effectiveness of the workshop, the skill evaluation tests and the questionnaire survey were conducted. Results: Fourteen pediatric surgeons (response rate: 60.9%) responded to the needs assessment survey. More than 70% of the participants did not have any experience with advanced endosurgical procedures. However, advanced endosurgical procedures were strongly needed. A lack of training was indicated as a major barrier for the introduction of pediatric endosurgery. Fifteen participants completed the workshop. Participants' confidence in their endosurgical skills improved significantly after the workshop. The skill evaluation tests revealed that participants' endosurgical skills also improved significantly after the workshop, although even after the workshop, participants still took an average of 415.6 seconds to place and knot one suture. Conclusions: The needs assessment survey and workshop for Nepalese pediatric surgeons helped clarify their needs for endosurgery and the barriers to its introduction.
• 外科修練医は何を求めてるのか? 日本外科学会専門医取得に関する全国アンケート調査から
  橋本 大輔; 里井 壯平; 関本 貢嗣; サシーム・パウデル; 倉島 庸; 平野 聡
  日本臨床外科学会雑誌, 82, 増刊, S62, S62, 日本臨床外科学会, 2021年10月
  日本語
• コロナ禍における世界の外科教育の現状と展望
  倉島 庸; サシーム・パウデル; 渡邊 祐介; 海老原 裕磨; 村上 壮一; 七戸 俊明; 平野 聡
  日本内視鏡外科学会雑誌, 25, 7, BSP2, 1, (一社)日本内視鏡外科学会, 2021年03月
  日本語
• コロナ禍における腹腔鏡下手術遠隔シミュレーショントレーニングシステムの開発
  桐山 琴衣; 倉島 庸; サシーム・パウデル; 渡邊 祐介; 海老原 裕磨; 村上 壮一; 七戸 俊明; 平野 聡
  日本内視鏡外科学会雑誌, 25, 7, BSP2, 4, (一社)日本内視鏡外科学会, 2021年03月
  日本語
• コロナ禍における腹腔鏡下手術遠隔シミュレーショントレーニングシステムの開発
  桐山 琴衣; 倉島 庸; サシーム・パウデル; 渡邊 祐介; 海老原 裕磨; 村上 壮一; 七戸 俊明; 平野 聡
  日本内視鏡外科学会雑誌, 25, 7, BSP4, 3, (一社)日本内視鏡外科学会, 2021年03月
  日本語
• コロナ禍における世界の外科教育の現状と展望
  倉島 庸; サシーム・パウデル; 渡邊 祐介; 海老原 裕磨; 村上 壮一; 七戸 俊明; 平野 聡
  日本内視鏡外科学会雑誌, 25, 7, BSP2, 1, (一社)日本内視鏡外科学会, 2021年03月
  日本語
• コロナ禍における腹腔鏡下手術遠隔シミュレーショントレーニングシステムの開発
  桐山 琴衣; 倉島 庸; サシーム・パウデル; 渡邊 祐介; 海老原 裕磨; 村上 壮一; 七戸 俊明; 平野 聡
  日本内視鏡外科学会雑誌, 25, 7, BSP2, 4, (一社)日本内視鏡外科学会, 2021年03月
  日本語
• コロナ禍における腹腔鏡下手術遠隔シミュレーショントレーニングシステムの開発
  桐山 琴衣; 倉島 庸; サシーム・パウデル; 渡邊 祐介; 海老原 裕磨; 村上 壮一; 七戸 俊明; 平野 聡
  日本内視鏡外科学会雑誌, 25, 7, BSP4, 3, (一社)日本内視鏡外科学会, 2021年03月
  日本語
• A new technique to avoid unintentional adhesion while deploying ProGrip mesh and its utility in the laparoscopic repair of obturator hernia.
  Jun Muto; Katsuhiko Murakawa; Hiroyuki Yamamoto; Saseem Poudel; Shoki Sato; Kohei Kato; Naoto Senmaru; Koichi Ono
  Journal of minimal access surgery, 17, 1, 116, 119, 2021年, ［国際誌］
  英語, 研究論文（学術雑誌）, The ProGrip™ laparoscopic self-fixating mesh provides advantages such as low cost and reduced pain following tack-free fixation in laparoscopic hernia repair through a transabdominal preperitoneal approach. Obturator hernia repair needs adequate fixation around the hernial orifice without the use of tacking, and ProGrip™ mesh provides options for secure fixation. However, it is often difficult to adequately adjust the mesh placement to cover the obturator hernia orifice with a ProGrip™ mesh, due to adhesion of the grips to the surrounding tissues. We introduce our technique to avoid unintentional adhesion during ProGrip mesh repair and discuss its utility in the treatment of obturator hernias. We repaired seven obturator hernia lesions in five patients using this technique without any complications. The biggest advantage of our technique is that the position of the mesh can be adjusted after it is expanded, unless the sheet is completely removed, allowing the surgeons to fix the mesh without any unintended adhesion to surrounding tissue.
• 当院における高齢者乳癌治療の現状
  齋藤 崇宏; 東海林 安人; 氏家 菜々美; 石堂 敬太; サシーム・パウデル; 佐藤 彰記; 武藤 潤; 長谷 龍之介; 仙丸 直人
  日本乳癌学会総会プログラム抄録集, 28回, 208, 208, (一社)日本乳癌学会, 2020年10月
  日本語
• 発展途上国での手術経験と国際貢献 Global Pediatric Surgeryとしてのネパールでの小児内視鏡外科手術導入の支援へ向けたワークショップ開催
  村上 雅一; サシーム・パウデル; 福原 雅弘; 加治 建; 野口 啓幸; 倉島 庸; 家入 里志
  日本小児外科学会雑誌, 56, 5, 559, 559, (一社)日本小児外科学会, 2020年09月
  日本語
• 急速に進行した大腸原発神経内分泌癌の二症例
  氏家 菜々美; 佐藤 彰記; 石堂 敬太; 齋藤 崇宏; パウデル・サシーム; 武藤 潤; 東海林 安人; 長谷 龍之介; 仙丸 直人
  日本外科学会定期学術集会抄録集, 120回, RS, 10, (一社)日本外科学会, 2020年08月
  日本語
• 学術研究分野としての外科教育研究
  渡邊 祐介; 倉島 庸; Poudel Saseem; 溝田 朋子; 水沼 謙一; 横山 新一郎; 七戸 俊明; 平野 聡
  日本外科学会定期学術集会抄録集, 120回, SSF, 1, (一社)日本外科学会, 2020年08月
  日本語
• 臨床解剖学実習の医学部教育カリキュラム導入に向けた取り組み
  村上 壮一; 七戸 俊明; 倉島 庸; サシーム・パウデル; 楢崎 肇; 松井 あや; 田中 公貴; 中西 喜嗣; 浅野 賢道; 野路 武寛; 海老原 裕磨; 中村 透; 土川 貴裕; 岡村 圭祐; 石田 稔; 高橋 誠; 渡辺 雅彦; 平野 聡
  医学教育, 51, Suppl., 81, 81, (一社)日本医学教育学会, 2020年07月
  日本語
• 臨床解剖学実習の医学部教育カリキュラム導入に向けた取り組み
  村上 壮一; 七戸 俊明; 倉島 庸; サシーム・パウデル; 楢崎 肇; 松井 あや; 田中 公貴; 中西 喜嗣; 浅野 賢道; 野路 武寛; 海老原 裕磨; 中村 透; 土川 貴裕; 岡村 圭祐; 石田 稔; 高橋 誠; 渡辺 雅彦; 平野 聡
  医学教育, 51, Suppl., 81, 81, (一社)日本医学教育学会, 2020年07月
  日本語
• Is there disparity between regions and facilities in surgical resident training in Japan? Insights from a national survey
  Daisuke Hashimoto; Saseem Poudel; Satoshi Hirano; Yo Kurashima; Hirotoshi Akiyama; Susumu Eguchi; Toshihiro Fukui; Masaru Hagiwara; Koya Hida; Tomoko Izaki; Hirotaka Iwase; Shunsuke Kawamoto; Yasuhiro Otomo; Eishi Nagai; Mitsue Saito; Hideki Takami; Yuko Takeda; Masakazu Toi; Hiroki Yamaue; Motofumi Yoshida; Shigetoshi Yoshida; Takao Ohki; Yasuhiro Kodera
  Surgery Today, 50, 12, 1585, 1593, Springer Science and Business Media LLC, 2020年06月02日, ［査読有り］, ［国内誌］
  英語, 研究論文（学術雑誌）
• Continuation of antithrombotic therapy increases minor bleeding but does not increase the risk other morbidities in open inguinal hernia repair: A propensity score-matched analysis.
  S Poudel; K Miyazaki; S Hirano
  Hernia : the journal of hernias and abdominal wall surgery, 2020年03月11日, ［査読有り］, ［国際誌］
  英語, PURPOSE: An aging population has led to an increased number of patients with cardiovascular comorbidities requiring antithrombotic therapy. Perioperatively, surgeons should consider the increased risk of bleeding and thrombotic events in patients continuing or discontinuing these medications. We aimed to analyze the safety of continued antithrombotic therapy during open inguinal hernia repair. METHODS: In this single-center, retrospective study, 4870 adult patients who underwent open inguinal hernia repair surgery by the same surgeon from 2008 January to 2019 March were included. Patients who underwent surgery while continuing antithrombotic therapy were included in the antithrombin group (n = 523) while those who were not under any antithrombotic therapy during the surgery were included in the control group (n = 4333). Using propensity score-matching, we then selected patients from each group with similar backgrounds. Surgery time, anesthesia time, postoperative bleeding, reoperation, and thrombotic event data were compared between the groups. Subgroup analysis based on the type of medications used was performed within the antithrombin group. RESULTS: Ten patients in the antithrombin group and seven patients in the control group experienced postoperative bleeding (p < 0.001). The rate of postoperative bleeding was the highest in patients taking multiple medications. However, most were managed conservatively. Three patients from the antithrombin group experienced thrombotic events postoperatively (p = 0.001). CONCLUSIONS: Patients receiving continued antithrombotic therapy had an increased risk of minor postoperative bleeding; however, they are a high-risk group for thrombotic events.
• Are graduating residents sufficiently competent? Results of a national gap analysis survey of program directors and graduating residents in Japan.
  Saseem Poudel; Satoshi Hirano; Yo Kurashima; Dimitrios Stefanidis; Hirotoshi Akiyama; Susumu Eguchi; Toshihiro Fukui; Masaru Hagiwara; Daisuke Hashimoto; Koya Hida; Tomoko Izaki; Hirotaka Iwase; Shunsuke Kawamoto; Yasuhiro Otomo; Eishi Nagai; Mitsue Saito; Hideki Takami; Yuko Takeda; Masakazu Toi; Hiroki Yamaue; Motofumi Yoshida; Shigetoshi Yoshida; Yasuhiro Kodera
  Surgery today, 50, 9, 995, 1001, 2020年03月03日, ［査読有り］, ［国内誌］
  英語, 研究論文（学術雑誌）, PURPOSE: To evaluate the self-assessed competency of graduating residents (GRs) in Japan upon completion of their residency and to identify the gap between their competency and the competency expected by their program directors (PDs). METHOD: A list of 31 essential surgical procedures was compiled according to the consensus of surgical educators from around the country. A survey with this list was sent to all 909 GRs and their 611 PDs in 2016. The GRs rated their competency to perform these procedures and the PDs were asked to evaluate the expected competency of their GRs using the Zwisch Scale. RESULT: The response rate was 56.3% for the GRs and 76.8% for the PDs. Fewer than half of the GRs who responded felt confident performing ten (32%) of the surgical procedures evaluated. For most procedures, the GRs' self-reported competency was lower than the expectation reported by their PDs. This gap was more than 10% for 13 of the procedures. CONCLUSION: More than half of the GRs in Japan lacked the confidence in their skill to perform one-third of the surgical procedures selected for evaluation in this study. These findings should be used to update the surgical education curriculum in Japan.
• 鼠径ヘルニア修復術をどう教えるか 技能評価およびフィードバックを基盤とした初心者のための腹腔鏡下鼠径ヘルニア教育
  サシーム・パウデル; 倉島 庸; 田中 公貴; 川瀬 寛; 村上 慶洋; 川原田 陽; 平野 聡
  日本内視鏡外科学会雑誌, 24, 7, WS30, 7, (一社)日本内視鏡外科学会, 2019年12月
  日本語
• 技術認定を目指す前に! 安全な手術を行うための初心者向け技能評価による内視鏡外科教育
  倉島 庸; サシーム・パウデル; 渡邊 祐介; 溝田 知子; 楢崎 肇; 海老原 裕磨; 村上 壮一; 七戸 俊明; 平野 聡
  日本内視鏡外科学会雑誌, 24, 7, IT3, 5, (一社)日本内視鏡外科学会, 2019年12月
  日本語
• Perforation of small intestinal metastasis of lung adenocarcinoma treated with pembrolizumab: a case report.
  Sato S; Senmaru N; Ishido K; Saito T; Poudel S; Muto J; Syouji Y; Hase R; Hirano S
  Surgical case reports, 5, 1, 166, 166, 2019年10月, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, BACKGROUND: Pembrolizumab is an immune checkpoint inhibitor and is an anti-human programmed cell death-1 (PD-1) monoclonal antibody. Pembrolizumab is used for non-small cell lung carcinoma with high programmed cell death ligand-1 (PD-L1) expression. It has been found that better overall survival can be obtained using pembrolizumab compared to the existing chemotherapy. We report a case of perforation of small intestinal metastasis after pembrolizumab treatment. CASE PRESENTATION: A 62-year-old man was treated by pembrolizumab for PD-L1 highly expressed lung adenocarcinoma, with multiple metastasis (small intestinal, lymph nodes, and bone). The treatment was stopped owing to drug-induced pneumonitis. One month after drug withdrawal, the patient visited the emergency department of our hospital with the complaint of severe stomachache. He had a rigid abdomen and generalized tenderness, and computed tomography scans showed free air within the abdomen. We diagnosed bowel perforation and performed emergency surgery. Surgical findings revealed multiple small intestine metastasis and mesenteric lymph node metastasis. Perforation was found in the metastatic site in the jejunum located around 40 cm anal to Treitz's ligament. This perforated part was resected, and functional end-to-end anastomosis was performed using linear staplers. The post-operative course was uneventful. Pathological examination revealed lung adenocarcinoma metastasis at the perforation site, and the effectiveness of pembrolizumab was grade 1b (Japanese Classification of the Colorectal Carcinoma, seventh edition). CONCLUSIONS: This is the first report of perforation of small intestinal metastasis of lung adenocarcinoma after pembrolizumab treatment. Because pembrolizumab causes some side effects, particularly autoimmune side effects, careful attention during treatment is warranted.
• 日本外科学会専門医取得に関する全国アンケート調査から 大学と一般病院、大都市と地方に差があるのか?
  橋本 大輔; サシーム・パウデル; 倉島 庸; 福井 寿啓; 岩瀬 弘敬; 平野 聡; 大木 隆夫; 小寺 泰弘; 外科専門医修練カリキュラム検討ワーキンググループ
  日本臨床外科学会雑誌, 80, 増刊, 272, 272, 日本臨床外科学会, 2019年10月
  日本語
• A snapshot of surgical resident training in Japan: results of a national-level needs assessment survey.
  Saseem Poudel; Satoshi Hirano; Yo Kurashima; Dimitrios Stefanidis; Hirotoshi Akiyama; Susumu Eguchi; Toshihiro Fukui; Masaru Hagiwara; Daisuke Hashimoto; Koya Hida; Tomoko Izaki; Hirotaka Iwase; Shunsuke Kawamoto; Yasuhiro Otomo; Eishi Nagai; Mitsue Saito; Hideki Takami; Yuko Takeda; Masakazu Toi; Hiroki Yamaue; Motofumi Yoshida; Shigetoshi Yoshida; Yasuhiro Kodera
  Surgery today, 49, 10, 870, 876, 2019年10月, ［査読有り］, ［国内誌］
  英語, 研究論文（学術雑誌）, PURPOSE: To evaluate the status of surgical training in Japan through a national-level needs assessment. METHODS: A survey was sent to all 909 graduating residents (GRs) and their 611 program directors (PDs) for the year 2016. A working group of surgical educators from around the country was formed under the education committee of the Japan Surgical Society. The survey items were developed by consensus of this working group. The survey investigated the knowledge and problems of the current curriculum, and the status of the current residency training. RESULTS: The response rates were 56.3% of the GRs and 76.8% of the PDs. Among the participants, 47.6% of the GRs and 29.4% of the PDs believed that the residency curriculum did not match the clinical experience. Over 80% of the GRs and PDs agreed on the importance of training outside of the OR, whereas only 13% of the GRs had received such training regularly. Trainees also reported a lower satisfaction rate about the opportunity to train outside of the OR. CONCLUSION: This national-level needs assessment of surgical training in Japan identified several gaps in the curriculum. These results provide valuable data to assist the ongoing efforts for surgical residency curriculum improvement.
• Evaluation methods and impact of simulation-based training in pediatric surgery: a systematic review.
  Yokoyama S; Mizunuma K; Kurashima Y; Watanabe Y; Mizota T; Poudel S; Kikuchi T; Kawai F; Shichinohe T; Hirano S
  Pediatric surgery international, 35, 10, 1085, 1094, 2019年10月, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, PURPOSE: The aim of this study was to identify (1) the type of skill evaluation methods and (2) how the effect of training was evaluated in simulation-based training (SBT) in pediatric surgery. METHODS: Databases of PubMed, Cochrane Library, and Web of Science were searched for articles published from January 2000 to January 2017. Search concepts of Medical Subject Heading terms were "surgery," "pediatrics," "simulation," and "training, evaluation." RESULTS: Of 5858 publications identified, 43 were included. Twenty papers described simulators as assessment tools used to evaluate technical skills. Reviewers differentiated between experts and trainees using a scoring system (45%) and/or a checklist (25%). Simulators as training tools were described in 23 papers. While the training's effectiveness was measured using performance assessment scales (52%) and/or surveys (43%), no study investigated the improvement of the clinical outcomes after SBT. CONCLUSION: Scoring, time, and motion analysis methods were used for the evaluation of basic techniques of laparoscopic skills. Only a few SBT in pediatric surgery have definite goals with clinical effect. Future research needs to demonstrate the educational effect of simulators as assessment or training tools on SBT in pediatric surgery.
• 日本外科学会専門医取得に関する全国アンケート調査から地域間格差はあるのか?
  橋本 大輔; サシーム・パウデル; 倉島 庸; 福井 寿啓; 岩瀬 弘敬; 平野 聡; 大木 隆生; 小寺 泰弘; 外科専門医修練カリキュラム検討ワーキンググループ
  日本消化器外科学会総会, 74回, O7, 5, (一社)日本消化器外科学会, 2019年07月
  日本語
• Identifying the needs for teaching fundamental knowledge of laparoscopic surgery: a cross-sectional study in Japan.
  Shinichiro Yokoyama; Yusuke Watanabe; Yo Kurashima; Akihiko Oshita; Yuji Nishizawa; Takeshi Naitoh; Fumitaka Nakamura; Satoru Kikuchi; Kazuhiro Noma; Saseem Poudel; Akihiro Suzuki; Yuichi Nishihara; Masaaki Ito; Satoshi Hirano
  Surgical endoscopy, 33, 7, 2242, 2248, 2019年07月, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, BACKGROUND: Recently, laparoscopic surgery (LS) has become a more common procedure than traditional open surgery. Although LS-related adverse events have been reported, there is no formal, standardized curriculum to teach the fundamentals of LS in Japan. Understanding surgeons' knowledge regarding LS is crucial for developing an educational curriculum. The purpose of this study was to determine the baseline knowledge on LS of surgeons and surgical trainees in Japan. METHODS: Participants completed 24 multiple-choice questions testing basic cognitive knowledge of LS and a questionnaire regarding the status of laparoscopic education. The examination was developed according to the 13 content domains of the Fundamentals of Laparoscopic Surgery (FLS) program. Scores were compared between post-graduate year (PGY) > 5 and PGY 1-5 participants. Data are expressed as median scores and interquartile ranges. Wilcoxon signed-rank test was used for statistical analysis. RESULTS: A total of 195 surgeons and surgical trainees from 10 teaching hospitals (PGY1-5: 66, PGY > 5: 129) across Japan completed the examination. The median score in the entire cohort was 75 [67; 83] %, with significantly higher scores in the PGY > 5 group compared to the PGY1-5 group (79 [75; 83] % vs. 67 [58; 75] %, p < 0.001). The differences in performance were due to better scores for PGY > 5 group on the sections "equipment," "patient considerations," "abdominal access," "tissue handling," "hemorrhage and hemostasis," "tissue approximation," and "exiting the abdomen." Overall, the median scores in the "energy sources" and "establishment and physiology of the pneumoperitoneum" subsections were lower than in other domains. All participants agreed on the need for fundamental knowledge and a formal educational curriculum. CONCLUSIONS: Compared to experienced surgeons, surgical trainees had lesser knowledge about performing LS. Regardless of the years of experience, there are crucial knowledge gaps in specific areas regarding safe LS that should be addressed by implementing an educational curriculum.
• Identifying the Essential Portions of the Skill Acquisition Process Using Item Response Theory.
  Poudel S; Watanabe Y; Kurashima Y; Ito YM; Murakami Y; Tanaka K; Kawase H; Shichinohe T; Hirano S
  Journal of surgical education, 76, 4, 1101, 1106, 2019年02月, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）
• Development of a novel tool to assess skills in laparoscopic gastrectomy using the Delphi method: the Japanese operative rating scale for laparoscopic distal gastrectomy (JORS-LDG).
  Kurashima Y; Watanabe Y; Hiki N; Poudel S; Kitagami H; Ebihara Y; Murakami S; Shichinohe T; Hirano S
  Surgical endoscopy, 33, 12, 3945, 3952, 2019年02月, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, BACKGROUND: Assessment of the performance of laparoscopic gastrectomy is yet unreported, likely because of the complexity of the procedure. We aimed to develop a tool to assess the skills required for laparoscopic distal gastrectomy (LDG) through cognitive task analysis (CTA) and expert consensus using the Delphi method. METHODS: CTA involved the listing of the knowledge and criteria required for completing each step of LDG as subtasks based on interviews by experts and novices and text book, instructional video, and procedural review. The Delphi evaluation method involved anonymous online surveys, conducted to merge the opinions of experts in laparoscopic gastrectomy. The experts were asked to rate (from 1 to 5) the importance of subtasks for skill evaluation and training for LDG using a Likert scale. Consensus among expert viewpoints was determined by the internal consistency of each item using Cronbach's approach. RESULTS: Essential subtasks drafted for the assessment of LDG performance were determined based on the CTA. Thirty-one LDG experts participated in the online-survey with a response rate over 90%. A consensus was achieved after 2 rounds of surveys with a Cronbach alpha of 0.86, and 34 subtasks of LDG were selected. We finally created the Japanese Operative Rating Scale for Laparoscopic Distal Gastrectomy (JORS-LDG) based on the 34 subtasks. CONCLUSIONS: We developed the JORS-LDG using CTA and the Delphi method.
• Development of a novel training system for laparoscopic inguinal hernia repair.
  Poudel S; Kurashima Y; Kawarada Y; Murakami Y; Tanaka K; Kawase H; Shichinohe T; Hirano S
  Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy, 28, 4, 1, 7, 2018年09月, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）, Background: Laparoscopic inguinal hernia repair is considered technically difficult. Although a simulation-based curriculum has been developed to help trainees, access to simulation training outside North America is limited. This study aimed to develop an educational system for the transabdominal preperitoneal (TAPP) approach based on the TAPP checklist, an assessment tool we had developed and validated earlier. Material and methods: Consensus within the TAPP education working group consisting of local TAPP experts, hernia experts and a surgical educator to develop educational tools and the educational system based on the TAPP checklist. The system was piloted in several institutes, and participants were surveyed on its efficacy. Results: We systematically developed an educational video and training manual explaining each item of the TAPP checklist and conveying basic knowledge of the procedure. We integrated the training tool with evaluation and feedback to develop an educational system. In a pilot study, seven trainees at five hospitals were trained using this system and found it very useful for mastering the TAPP procedure. Conclusions: We have developed a training system for TAPP procedure and successfully implemented it in several hospitals. Further research will focus on the educational value of this tool.
• Step-by-step training in basic laparoscopic skills using two-way web conferencing software for remote coaching: A multicenter randomized controlled study
  Tomoko Mizota; Yo Kurashima; Saseem Poudel; Yusuke Watanabe; Toshiaki Shichinohe; Satoshi Hirano
  American Journal of Surgery, 216, 1, 88, 92, Elsevier Inc., 2018年07月01日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）
• Educational system based on the TAPP checklist improves the performance of novices: a multicenter randomized trial
  Saseem Poudel; Yo Kurashima; Kimitaka Tanaka; Hiroshi Kawase; Yoichi M. Ito; Fumitaka Nakamura; Toshiaki Shichinohe; Satoshi Hirano
  Surgical Endoscopy and Other Interventional Techniques, 32, 5, 2480, 2487, Springer New York LLC, 2018年05月01日, ［査読有り］
  英語, 研究論文（学術雑誌）
• Two cases of laparoscopic direct spiral closure of large defects in the second portion of the duodenum after laparoscopic endoscopic co-operative surgery
  Saseem Poudel; Yuma Ebihara; Kimitaka Tanaka; Yo Kurashima; Soichi Murakami; Toshiaki Shichinohe; Satoshi Hirano
  Journal of Minimal Access Surgery, 14, 2, 149, 153, Medknow Publications, 2018年04月01日, ［査読有り］, ［国際誌］
  英語, 研究論文（学術雑誌）
• 外科医のトレーニング-技術の継承とは- 術式別技能評価スケールを基盤とした内視鏡外科手術トレーニングプログラムの構築
  倉島 庸; Saseem Poudel; 渡邊 祐介; 中西 喜嗣; 浅野 賢道; 野路 武寛; 海老原 裕磨; 村上 壮一; 中村 透; 土川 貴裕; 岡村 圭祐; 七戸 俊明; 平野 聡
  日本外科学会定期学術集会抄録集, 118回, 256, 256, (一社)日本外科学会, 2018年04月
  日本語
• Impact of 3D in the training of basic laparoscopic skills and its transferability to 2D environment: a prospective randomized controlled trial
  Saseem Poudel; Yo Kurashima; Yusuke Watanabe; Yuma Ebihara; Eiji Tamoto; Soichi Murakami; Toru Nakamura; Takahiro Tsuchikawa; Keisuke Okamura; Toshiaki Shichinohe; Satoshi Hirano
  SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 31, 3, 1111, 1118, 2017年03月, ［査読有り］
  英語, 研究論文（学術雑誌）
• Development and validation of a checklist for assessing recorded performance of laparoscopic inguinal hernia repair
  Saseem Poudel; Yo Kurashima; Yo Kawarada; Yusuke Watanabe; Yoshihiro Murakami; Yoshiyuki Matsumura; Hiroaki Kato; Kyosuke Miyazaki; Toshiaki Shichinohe; Satoshi Hirano
  AMERICAN JOURNAL OF SURGERY, 212, 3, 468, 474, 2016年09月, ［査読有り］
  英語, 研究論文（学術雑誌）
• Evaluation of hands-on seminar for reduced port surgery using fresh porcine cadaver model
  Saseem Poudel; Yo Kurashima; Toshiaki Shichinohe; Shuji Kitashiro; Eiji Kanehira; Satoshi Hirano
  JOURNAL OF MINIMAL ACCESS SURGERY, 12, 3, 214, 219, 2016年07月, ［査読有り］
  英語, 研究論文（学術雑誌）
• Intraluminal continuous decompression and drainage using a vacuum pump for controlling cervical anastomotic leakage after a three-field esophagectomy with a gastric pull-up
  Toshiaki Shichinohe; Yuma Ebihara; Soichi Murakami; Yo Kurashima; Naoya Fukuda; Saseem Poudel; Dai Miyazaki; Takahiro Tsuchikawa; Satoshi Hirano
  ESOPHAGUS, 13, 2, 229, 233, 2016年04月, ［査読有り］
  英語, 研究論文（学術雑誌）
• Liquid-injection for preperitoneal dissection of transabdominal preperitoneal (TAPP) inguial hernia repair
  Tomoko Mizota; Yusuke Watanabe; Amin Madani; Norihiro Takemoto; Hidehisa Yamada; Saseem Poudel; Yuji Miyasaka; Yo Kurashima
  SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 29, 3, 516, 520, 2015年03月, ［査読有り］
  英語, 研究論文（学術雑誌）
• Liquid-injection for preperitoneal dissection of transabdominal preperitoneal (TAPP) inguinal hernia repair (vol 29, pg 516, 2015)
  Tomoko Mizota; Yusuke Watanabe; Amin Madani; Norihiro Takemoto; Hidehisa Yamada; Saseem Poudel; Yuji Miyasaka; Yo Kurashima
  SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 29, 3, 521, 521, 2015年03月, ［査読有り］
  英語
• 認知タスク分析による腹腔鏡下幽門側胃切除術の視覚・言語化と技能評価スコアの開発
  倉島 庸; 渡邊 祐介; サシーム・パウデル; 海老原 裕磨; 村上 壮一; 田本 英司; 中村 透; 土川 貴裕; 岡村 圭祐; 七戸 俊明; 平野 聡
  日本内視鏡外科学会雑誌, 19, 7, 288, 288, (一社)日本内視鏡外科学会, 2014年10月
  日本語
• TAPPチェックリストを用いた腹腔鏡下鼠径ヘルニア修復術(TAPP)手技および評価者教育セミナー
  サシーム・パウデル; 倉島 庸; 渡邊 祐介; 村上 慶洋; 川原田 陽; 七戸 俊明; 平野 聡
  日本内視鏡外科学会雑誌, 19, 7, 610, 610, (一社)日本内視鏡外科学会, 2014年10月
  日本語
• A new marking technique for peripheral lung nodules avoiding pleural puncture: the intrathoracic stamping method
  Masaya Kawada; Tetsuyuki Okubo; Saseem Poudel; Yoshinori Suzuki; Yo Kawarada; Shuji Kitashiro; Shunichi Okushiba; Hiroyuki Katoh
  INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY, 16, 3, 381, 383, 2013年03月, ［査読有り］
  英語, 研究論文（学術雑誌）

• 腹腔鏡下に修復した再発性食道裂孔ヘルニア(IV型)の1例
  桐山亜斗夢; 高野博信; パウデル サシーム; 和田秀之; 新田健雄; 村上壮一; 七戸俊明; 平野聡, 北海道「ヘルニアを学ぶ会」プログラム・抄録集, 18th, 2025年
• 広いヘルニア門を有する再発鼠径ヘルニアに対しeTEP法により修復した1例
  佐藤謙太郎; パウデル サシーム; 高野博信; 和田秀之; 新田健雄; 武内慎太郎; 和田雅孝; 田中公貴; 松井あや; 中西喜嗣; 浅野賢道; 村上壮一; 七戸俊明; 平野聡, 北海道「ヘルニアを学ぶ会」プログラム・抄録集, 18th, 2025年
• 倉島先生を思い出して
  サシーム パウデル, 医学教育, 55, 6, 502, 502, 2024年12月25日
  日本医学教育学会, 日本語
• 特集 術前画像診断-どう読んで,どう備えるか? II. 各論 1. 食道 2)ロボット手術を行うにあたり確認･注意すべき画像診断
  北上 英彦; 北山 陽介; パウデル サシーム; 鯉沼 潤吉; 藤原 有史; 財津 有里, 外科, 86, 9, 979, 984, 2024年08月01日
  南江堂, 日本語
• 外科修練医の求める勤務とは?-外科学会全国アンケート調査二次解析-
  山岡(藤川)善子; 山岡(藤川)善子; 高村卓志; 須田千秋; 小西孝明; 山本直宗; 石田苑子; 阿部朋未; 谷河篤; パウデル サシーム; 喜安佳之; 齋藤光江, 日本臨床外科学会雑誌(Web), 85, Supplement, 2024年
• 外科修練地による地域格差の実態と若手外科医が地方都市での勤務に求めること
  渡邉元己; 渡邉元己; 林沙貴; 林沙貴; 喜安佳之; 喜安佳之; 小西孝明; 小西孝明; POUDEL Saseem; POUDEL Saseem; 福本将之; 福本将之; 古来貴寛; 古来貴寛; 野村信介; 野村信介; 山本直宗; 山本直宗; 渡部純; 渡部純; 齊藤光江; 齊藤光江, 日本臨床外科学会雑誌(Web), 85, Supplement, 2024年
• 課題解決を目指す外科教育研究の実践と普及への取り組み
  倉島庸; パウデル サシーム; 海老原裕磨; 村上壮一; 七戸俊明; 平野聡, 日本外科学会定期学術集会(Web), 124th, 2024年
• 若手外科医のための遠隔シミュレーショントレーニング開発~無作為化比較試験による有用性の検討~
  桐山琴衣; 倉島庸; パウデル サシーム; 渡邊祐介; 海老原裕磨; 村上壮一; 七戸俊明; 平野聡, 日本消化器外科学会雑誌(Web), 56, Supplement1, 2023年
• Direct Kugel法—総特集 鼠径部切開法を見直す
  宮崎 恭介; パウデル サシーム, 手術 = Operation, 76, 6, 917, 923, 2022年05月
  東京 : 金原出版, 日本語
• 外科専門医カリキュラムにおけるサブスペシャルティキャリアの課題と展望—CHALLENGES AND PROSPECTS OF SUBSPECIALTY CAREER IN SURGICAL RESIDENCY TRAINING SYSTEM—第120回日本外科学会定期学術集会 ; 外科系新専門医制度のあるべきグランドデザイン
  サシーム パウデル; 倉島 庸; 平野 聡; 小寺 泰弘; 大木 隆生, 日本外科学会雑誌 = Journal of Japan Surgical Society / 日本外科学会 編, 122, 1, 80, 82, 2021年
  東京 : 日本外科学会, 日本語
• 技能評価とフィードバックを基盤とした理想的な腹腔鏡下ヘルニア教育の提案
  サシーム パウデル; 倉島庸; 田中公貴; 川瀬寛; 村上慶洋; 川原田陽; 平野聡, 日本ヘルニア学会学術集会抄録集(CD-ROM), 18th, 2020年
• 日本外科学会専門医取得に関する全国アンケート調査から地域間格差はあるのか?
  橋本 大輔; サシーム・パウデル; 倉島 庸; 福井 寿啓; 岩瀬 弘敬; 平野 聡; 大木 隆生; 小寺 泰弘; 外科専門医修練カリキュラム検討ワーキンググループ, 日本消化器外科学会総会, 74回, O7, 5, 2019年07月
  (一社)日本消化器外科学会, 日本語
• サブスペシャル領域を見据えた新専門医制度のあり方 本邦における外科専門医研修の現状に関する全国アンケート調査結果報告
  サシーム・パウデル; 平野 聡; 小寺 泰弘; 外科専門医修練カリキュラム検討ワーキンググループ, 日本外科学会雑誌, 119, 5, 558, 560, 2018年09月
  平成28年度外科専門医認定試験の合格者909人およびその指導医606人に対してアンケートを実施し、回答率は修練医56.3%、指導医で76.8%であった。半数程度の修練医はカリキュラム内容が実際の修練と合致していないと考え、7割以上の修練医と半分以上の指導医が硬膜外麻酔の実施、Swan-Ganzの挿入とモニタリング、および心嚢穿刺などの手技がカリキュラムに記載されていることを認知していなかった。6割の修練医は達成目標に含まれる外傷症例の経験に困難を感じ、8割の修練医と9割の指導医が手術室外でのトレーニングが必要と考えていたが、実際に定期的に行われていたのは1〜2割の施設であった。手技の自立度調査では、脾臓摘出術、肺胞切除術、甲状腺腫瘤摘出術に関して大半を自ら行えると自己評価した修練医は25%以下で、これらの手術手技は指導医の期待するレベルと修練医の自己評価の差が30%以上と著しく異なった。全身麻酔手術の総執刀数が100例以下で外科専門医を取得した修練医が7%存在し、彼らの手術手技に対する自立度は全体に比較して明らかに低かった。, (一社)日本外科学会, 日本語
• Regorafenib投与後に直腸会陰瘻をきたした1例
  渡邊 一永; サシーム・パウデル; 佐藤 彰記; 大高 和人; 細井 勇人; 東海林 安人; 長谷 龍之介; 仙丸 直人, 日本臨床外科学会雑誌, 79, 6, 1334, 1334, 2018年06月
  日本臨床外科学会, 日本語
• 外科医のトレーニング-技術の継承とは- 術式別技能評価スケールを基盤とした内視鏡外科手術トレーニングプログラムの構築
  倉島 庸; Saseem Poudel; 渡邊 祐介; 中西 喜嗣; 浅野 賢道; 野路 武寛; 海老原 裕磨; 村上 壮一; 中村 透; 土川 貴裕; 岡村 圭祐; 七戸 俊明; 平野 聡, 日本外科学会定期学術集会抄録集, 118回, 256, 256, 2018年04月
  (一社)日本外科学会, 日本語
• サブスペシャル領域を見据えた新専門医制度のあり方 本邦における外科専門医研修の現状に関する全国アンケート調査結果報告
  サシーム・パウデル; 平野 聡; 小寺 泰弘; 外科専門医修練カリキュラム検討ワーキンググループ, 日本外科学会定期学術集会抄録集, 118回, 228, 228, 2018年04月
  (一社)日本外科学会, 日本語
• 腹腔鏡下鼠径ヘルニア修復術における5mmポート3本での有用性 当院での経験
  サシーム・パウデル; 渡邊 一永; 佐藤 彰記; 大高 和人; 細井 勇人; 東海林 安人; 長谷 龍之介; 仙丸 直人; 平野 聡, 日本外科学会定期学術集会抄録集, 118回, 1325, 1325, 2018年04月
  (一社)日本外科学会, 日本語
• 技能評価に基づくフィードバックは手術技能を向上させる:多施設共同無作為比較試験
  POUDEL Saseem; POUDEL Saseem; 倉島庸; 田中公貴; 川瀬寛; 川瀬寛; 中村文隆; 七戸俊明; 平野聡, 日本ヘルニア学会学術集会抄録集(CD-ROM), 16th, 147, 2018年
  日本語
• 効率的なシミュレーショントレーニングを目指した、腹腔鏡下鼠径ヘルニア手術技能評価解析
  サシーム・パウデル; 倉島 庸; 渡邊 祐介; 溝田 知子; 渡邊 一永; 佐藤 彰記; 細井 勇人; 東海林 安人; 仙丸 直人; 七戸 俊明; 平野 聡, 日本内視鏡外科学会雑誌, 22, 7, SF008, 02, 2017年12月
  (一社)日本内視鏡外科学会, 日本語
• 手術技能評価は術中術後の手術成績を反映するか? 腹腔鏡下胃切除術技能評価スケールの妥当性検討
  倉島 庸; 渡邊 祐介; サシーム・パウデル; 浅野 賢道; 中西 喜嗣; 野路 武寛; 海老原 裕磨; 村上 壮一; 中村 透; 土川 貴裕; 岡村 圭祐; 七戸 俊明; 平野 聡, 日本内視鏡外科学会雑誌, 22, 7, EP019, 04, 2017年12月
  (一社)日本内視鏡外科学会, 日本語
• 安全な腹腔鏡下手術の実施に必要な基本的知識の理解度調査 課題と今後のカリキュラム開発に向けて
  横山 新一郎; 渡邊 祐介; 倉島 庸; 大下 彰彦; 西澤 祐吏; 工藤 克昌; 中村 文隆; 菊地 覚次; サシーム・パウデル; 鈴木 研裕; 西原 佑一; 鈴木 善法; 七戸 俊明; 平野 聡, 日本内視鏡外科学会雑誌, 22, 7, EP042, 05, 2017年12月
  (一社)日本内視鏡外科学会, 日本語
• Development and Validation of the Assessment Tool for the Education of Laparoscopic Gastrectomy: A Multi-Center Study
  Yo Kurashima; Hidehiko Kitagami; Koichi Teramura; Yusuke Watanabe; Saseem Poudel; Yuma Y. E. Ebihara; Soichi Murakami; Toshiaki Shichinohe; Satoshi Hirano, JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 225, 4, E152, E152, 2017年10月
  英語, 研究発表ペーパー・要旨（国際会議）
• 若手外科医の声 ネパールに日本の優れた外科技術を持ち帰るために 日本の外科の国際化を目指して
  サシーム・パウデル, 日本外科学会雑誌, 118, 4, 392, 393, 2017年07月
  (一社)日本外科学会, 日本語
• 腹腔鏡下胃切除術教育のための技能評価スケール開発と有用性検討 多施設共同研究
  倉島 庸; 渡邊 祐介; サシーム・パウデル; 海老原 裕磨; 村上 壮一; 七戸 俊明; 平野 聡, 日本外科学会定期学術集会抄録集, 117回, CSS, 9, 2017年04月
  (一社)日本外科学会, 日本語
• 腹腔鏡下鼠径ヘルニア修復術の新しいトレーニングシステムの開発及び教育効果の検討 多施設無作為比較試験
  Poudel Saseem; 倉島 庸; 田中 公貴; 川瀬 寛; 村上 康洋; 川原田 陽; 伊藤 陽一; 七戸 俊明; 平野 聡, 日本外科学会定期学術集会抄録集, 117回, SF, 51, 2017年04月
  (一社)日本外科学会, 日本語
• 安全な手術教育へ向けて 腹腔鏡下胃切除術技能評価スケールの多施設共同妥当性研究(Multicenter validation study of the skill evaluation scale of laparoscopic gastrectomy)
  倉島 庸; 渡邊 祐介; サシーム・パウデル; 海老原 裕磨; 村上 壮一; 七戸 俊明; 平野 聡, 日本胃癌学会総会記事, 89回, 267, 267, 2017年03月
  (一社)日本胃癌学会, 英語
• 腹腔鏡下鼠径ヘルニア修復術の新しい教育システムの有用性検討:多施設無作為比較試験
  SASEEM Poudel; SASEEM Poudel; 倉島庸; 田中公貴; 川瀬寛; 川瀬寛; 川原田陽; 村上慶洋; 伊藤陽一; 中村文隆; 七戸俊明; 平野聡, 日本ヘルニア学会学術集会抄録集(CD-ROM), 15th, ROMBUNNO.SY2‐2, 2017年
  日本語
• 3D環境下の修練は2Dで再現可能か?内視鏡外科トレーニングにおける2Dと3D環境の影響に関する無作為比較検討
  Poudel Saseem; 倉島 庸; 渡邊 祐介; 田中 公貴; 海老原 裕磨; 野路 武寛; 村上 壮一; 中村 透; 土川 貴裕; 岡村 圭祐; 七戸 俊明; 平野 聡, 日本内視鏡外科学会雑誌, 21, 7, OS213, 6, 2016年12月
  (一社)日本内視鏡外科学会, 日本語
• 食道癌術後縫合不全に対する当科での工夫
  上村 志臣; 七戸 俊明; サシーム・パウデル; 田中 公貴; 川瀬 寛; 海老原 裕磨; 倉島 庸; 村上 壮一; 平野 聡, 北海道医学雑誌, 91, 2, 96, 97, 2016年11月
  北海道医学会, 日本語
• 食道癌術後縫合不全に対する当科での工夫
  上村 志臣; 七戸 俊明; サシーム・パウデル; 田中 公貴; 川瀬 寛; 海老原 裕磨; 倉島 庸; 村上 壮一; 平野 聡, 北海道医学雑誌, 91, 2, 96, 97, 2016年11月
  北海道医学会, 日本語
• 低侵襲性手術のトレーニング 技の磨練に向けて 初心者に安全な手技を教えるために 腹腔鏡下鼠径ヘルニア修復術トレーニングシステムの構築
  Poudel Saseem; 倉島 庸; 川原田 陽; 村上 慶洋; 田中 公貴; 川瀬 寛; 七戸 俊明; 平野 聡, 日本臨床外科学会雑誌, 77, 増刊, 361, 361, 2016年10月
  日本臨床外科学会, 日本語
• 食道癌胃壁内転移の一例
  小野 雅人; 海老原 裕磨; 溝田 知子; サシーム・パウデル; 田中 公貴; 川瀬 寛; 中西 喜嗣; 浅野 賢道; 倉島 庸; 村上 壮一; 中村 透; 田本 英司; 土川 貴裕; 岡村 圭祐; 七戸 俊明; 上野 峰; 平野 聡, 日本臨床外科学会雑誌, 77, 9, 2335, 2335, 2016年09月
  日本臨床外科学会, 日本語
• 新たな専門医制度で、医学教育学会に期待されるものは何か? 新しい専門医制度における外科医教育の展望と学会が果たすべき役割
  倉島 庸; 溝田 知子; サシーム・パウデル; 渡邊 祐介; 村上 壮一; 平野 聡; 大滝 純司, 医学教育, 47, Suppl., 43, 43, 2016年07月
  (一社)日本医学教育学会, 日本語
• 消化器外科における診療参加型実習の試み
  村上 壮一; 倉島 庸; 平野 聡; 七戸 俊明; 岡村 圭祐; 土川 貴裕; 中村 透; 田本 英司; 海老原 裕磨; 野路 武寛; 浅野 賢道; 中西 喜嗣; 田中 公貴; 川瀬 寛; 三井 潤; サシーム・パウデル; 溝田 知子; 大滝 純司, 医学教育, 47, Suppl., 106, 106, 2016年07月
  (一社)日本医学教育学会, 日本語
• 白熱したカンファレンス中でも学生が質問できるように 新しい臨床実習支援ツールの開発
  村上 壮一; 倉島 庸; 遠藤 晃; 沼田 光哉; 伊藤 豊; サシーム・パウデル; 溝田 知子; 小華和 柾志; 川畑 秀伸; 七戸 俊明; 平野 聡; 大滝 純司, 医学教育, 47, Suppl., 127, 127, 2016年07月
  (一社)日本医学教育学会, 日本語
• 当科における食道内視鏡外科手術20年の変遷と治療成績
  七戸 俊明; 村上 壮一; 海老原 祐磨; 倉島 庸; 田中 公貴; 川瀬 寛; サシーム・パウデル; 土川 貴裕; 岡村 圭祐; 平野 聡, 日本食道学会学術集会プログラム・抄録集, 70回, 86, 86, 2016年07月
  (NPO)日本食道学会, 日本語
• 食道癌術後縫合不全に対する電動式低圧吸引器を用いた治療法
  上村 志臣; 七戸 俊明; サシームパウデル; 田中 公貴; 川瀬 寛; 海老原 裕磨; 倉島 庸; 村上 壮一; 平野 聡, 日本食道学会学術集会プログラム・抄録集, 70回, 200, 200, 2016年07月
  (NPO)日本食道学会, 日本語
• 若手外科医育成のための工夫 腹腔鏡下手術教育のための技能評価スケール開発とその実践 大学病院と関連病院の取り組み
  倉島 庸; 渡邊 祐介; サシーム・パウデル; 溝田 知子; 川瀬 寛; 田中 公貴; 海老原 裕磨; 村上 壮一; 七戸 俊明; 平野 聡, 日本消化器外科学会総会, 71回, WS1, 3, 2016年07月
  (一社)日本消化器外科学会, 日本語
• 腹腔内出血を来した腎癌大網転移の1例
  吉見 泰典; 海老原 裕磨; サシーム・パウデル; 川瀬 寛; 田中 公貴; 倉島 庸; 村上 壮一; 七戸 俊明; 平野 聡; 畑中 佳奈子, 北海道外科雑誌, 61, 1, 121, 121, 2016年06月
  北海道外科学会, 日本語
• 剥離可能層を意識した腹臥位手術による進行癌に対する鏡視下食道切除術
  七戸 俊明; 海老原 裕磨; 村上 壮一; 倉島 庸; 鯉沼 潤吉; 田中 公貴; 岡村 圭祐; 土川 貴裕; 中村 透; 田本 英司; 野路 武寛; 浅野 賢道; 中西 喜嗣; Poudel Saseem; 平野 聡, 日本外科学会定期学術集会抄録集, 116回, PS, 111, 2016年04月
  (一社)日本外科学会, 日本語
• 外傷外科の修練はどうあるべきか 外科医に外傷外科のCompetencyを与えるための「三位一体のDamage Control Surgeryトレーニングシステム」
  村上 壮一; 七戸 俊明; 倉島 庸; 岡村 圭祐; 土川 貴裕; 中村 透; 田本 英司; 海老原 裕磨; 野路 武寛; 浅野 賢道; 中西 喜嗣; 鯉沼 潤吉; 三井 潤; 川瀬 寛; 田中 公貴; サシーム・パウデル; 溝田 知子; 平野 聡, 日本外科学会定期学術集会抄録集, 116回, PD, 13, 2016年04月
  (一社)日本外科学会, 日本語
• 十二指腸腹腔鏡・内視鏡合同手術(LECS) 腹腔鏡下十二指腸欠損部の閉鎖法の工夫
  Poudel Saseem; 海老原 裕磨; 田中 公貴; 鯉沼 潤吉; 倉島 庸; 村上 壮一; 七戸 俊明; 平野 聡, 日本胃癌学会総会記事, 88回, 482, 482, 2016年03月
  (一社)日本胃癌学会, 日本語
• 完全腹腔鏡下噴門側胃切除Double Tract再建の治療成績 多施設共同研究
  田中 公貴; 海老原 裕磨; Saseem Poudel; 鯉沼 潤吉; 倉島 庸; 村上 壮一; 七戸 俊明; 平口 悦郎; 児嶋 哲文; 奥芝 俊一; 竹内 幹也; 平野 聡, 日本内視鏡外科学会雑誌, 20, 7, OS100, 3, 2015年12月
  (一社)日本内視鏡外科学会, 日本語
• 腹腔鏡下鼠径ヘルニア手術の標準化を目指して 手技の標準化へ向けた腹腔鏡下鼠径ヘルニア修復術教育プログラムの構築
  サシーム・パウデル; 倉島 庸; 渡邊 祐介; 川原田 陽; 村上 慶洋; 七戸 俊明; 平野 聡, 日本内視鏡外科学会雑誌, 20, 7, SY5, 8, 2015年12月
  (一社)日本内視鏡外科学会, 日本語
• 内視鏡外科/ロボット支援手術における安全管理 メディカルスタッフを含む合同シンポジウム エネルギーデバイス安全使用のためのハンズオンセミナー学習効果
  溝田 知子; 渡邊 祐介; Madani Amin; 倉島 庸; Poudel Saseem; 田中 公貴; 村上 壮一; 七戸 俊明; 平野 聡, 日本内視鏡外科学会雑誌, 20, 7, SY29, 4, 2015年12月
  (一社)日本内視鏡外科学会, 日本語
• 腹腔鏡下膵切除術のピットフォールとその対策 教室における腹腔鏡下脾臓温存膵体尾部切除術(LSPDP)の工夫と短期成績
  鯉沼 潤吉; 海老原 裕磨; サシーム・パウデル; 田中 公貴; 中西 喜嗣; 浅野 賢道; 倉島 庸; 野路 武寛; 田本 英司; 中村 透; 村上 壮一; 土川 貴裕; 岡村 圭祐; 七戸 俊明; 平野 聡, 日本内視鏡外科学会雑誌, 20, 7, WS26, 1, 2015年12月
  (一社)日本内視鏡外科学会, 日本語
• 食道粘膜下腫瘍に対する腹臥位胸腔鏡下腫瘍摘出術の有用性
  川瀬 寛; 海老原 裕磨; サシーム・パウデル; 倉島 庸; 村上 壮一; 中西 喜嗣; 浅野 賢道; 野路 武寛; 中村 透; 田本 英司; 土川 貴裕; 岡村 圭祐; 七戸 俊明; 平野 聡, 日本内視鏡外科学会雑誌, 20, 7, OS208, 7, 2015年12月
  (一社)日本内視鏡外科学会, 日本語
• 食道癌に対する鏡視下手術の生存因子とProne手術の優位性
  田中 公貴; 海老原 裕磨; Poudel Saseem; 鯉沼 潤吉; 倉島 庸; 村上 壮一; 七戸 俊明; 中西 喜嗣; 浅野 賢道; 野路 武寛; 田本 英司; 中村 透; 土川 貴裕; 岡村 圭祐; 平野 聡, 日本内視鏡外科学会雑誌, 20, 7, OS306, 3, 2015年12月
  (一社)日本内視鏡外科学会, 日本語
• 縦隔解剖に基づく剥離層を意識した腹臥位食道癌手術
  七戸 俊明; 海老原 祐磨; 倉島 庸; 村上 壮一; 鯉沼 潤吉; 田中 公貴; サシーム・パウデル; 溝田 知子; 土川 貴裕; 岡村 圭祐; 平野 聡, 日本内視鏡外科学会雑誌, 20, 7, OS309, 3, 2015年12月
  (一社)日本内視鏡外科学会, 日本語
• 上行大動脈弓部置換術後の大動脈食道瘻に対し、TEVAR内挿後、胸腔鏡下食道切除術を施行した一例
  上村 志臣; 七戸 俊明; 村上 壮一; 海老原 裕磨; 倉島 庸; 鯉沼 潤吉; 田中 公貴; サシーム・パウデル; 若狭 哲; 平野 聡, Japanese Journal of Acute Care Surgery, 5, 2, 211, 211, 2015年10月
  日本Acute Care Surgery学会, 日本語
• 胃粘膜下腫瘍に対する腹腔鏡・内視鏡合同胃局所切除術の一例
  枝村 達磨; サシーム・パウデル; 村上 壮一; 中西 喜嗣; 浅野 賢道; 野路 武寛; 倉島 庸; 海老原 裕磨; 中村 透; 田本 英司; 土川 貴裕; 岡村 圭祐; 七戸 俊明; 平野 聡, 日本臨床外科学会雑誌, 76, 増刊, 1186, 1186, 2015年10月
  日本臨床外科学会, 日本語
• 食道平滑筋腫に対する腹臥位胸腔鏡下腫瘍核出術
  溝田 知子; 七戸 俊明; サシーム・パウデル; 宮崎 大; 野路 武寛; 海老原 裕磨; 倉島 庸; 村上 壮一; 中村 透; 田本 英司; 松本 譲; 土川 貴裕; 岡村 圭祐; 平野 聡, 日本臨床外科学会雑誌, 76, 9, 2337, 2337, 2015年09月
  日本臨床外科学会, 日本語
• 遠位膵切除の術式と成績 局所進行膵体部癌に対するDP-CARの治療成績
  田本 英司; 櫛引 敏弘; サシーム・パウデル; 宮崎 大; 那須 裕也; 市之川 正臣; 鯉沼 潤吉; 福田 直也; 海老原 裕磨; 倉島 庸; 野路 武寛; 中村 透; 村上 壮一; 土川 貴裕; 岡村 圭祐; 七戸 俊明; 平野 聡, 日本肝胆膵外科学会・学術集会プログラム・抄録集, 27回, 394, 394, 2015年06月
  (一社)日本肝胆膵外科学会, 日本語
• 上部消化管 腹臥位食道切除術の定型化 腹側剥離先行の「三枚おろし法」によるen blocリンパ節郭清
  七戸 俊明; 海老原 裕磨; 倉島 庸; 村上 壮一; 金井 基錫; 宮崎 大; サシーム・パウデル; 土川 貴裕; 田本 英司; 中村 透; 岡村 圭祐; 平野 聡, 日本外科学会定期学術集会抄録集, 115回, OP, 124, 2015年04月
  (一社)日本外科学会, 日本語
• その他 基本的な内視鏡手術の研修に関する2Dおよび3D内視鏡システムの効果に関する比較研究(The comparative study on the effect of 2D and 3D endoscopic system on the training of basic endoscopic surgical procedures)
  Poudel Saseem; 倉島 庸; 溝田 智子; 本谷 康二; 宮崎 大; 海老原 裕磨; 田本 英司; 村上 壮一; 中村 透; 土川 貴裕; 七戸 俊明; 平野 聡, 日本外科学会定期学術集会抄録集, 115回, OP, 253, 2015年04月
  (一社)日本外科学会, 日本語
• インターネットカンファレンスを始める、広げる 「内視鏡外科チームテレカンファレンス」を実例に
  七戸 俊明; 村上 壮一; 倉島 庸; 海老原 裕磨; 金井 基錫; 宮崎 大; サシーム・パウデル; 松本 譲; 田本 英司; 中村 透; 土川 貴裕; 岡村 圭祐; 平野 聡, 日本内視鏡外科学会雑誌, 19, 7, 290, 290, 2014年10月
  (一社)日本内視鏡外科学会, 日本語
• HATSからProneへ、胸腔鏡下食道切除術の術式選択の根拠と手術遂行のための対策
  七戸 俊明; 海老原 裕磨; 倉島 庸; 村上 壮一; 金井 基錫; 宮崎 大; サシーム・パウデル; 松本 譲; 田本 英司; 中村 透; 土川 貴裕; 岡村 圭祐; 平野 聡, 日本内視鏡外科学会雑誌, 19, 7, 806, 806, 2014年10月
  (一社)日本内視鏡外科学会, 日本語
• Development and validation of the checklist for the evaluation and feedback of laparoscopic inguinal hernia repair using surgical video
  Saseem Poudel; Yoshihiro Y. M. Murakami; Yo Kurashima; Yo Kawarada; Yusuke Watanabe; Yoshiyuki Matsumura; Hiroaki Kato; Kyosuke Miyazaki; Toshiaki Shichinohe; Satoshi Hirano, JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 219, 4, E161, E162, 2014年10月
  英語, 研究発表ペーパー・要旨（国際会議）
• 当教室における若手外科医へのAcute Care Surgery教育の取り組み
  村上 壮一; 平野 聡; 七戸 俊明; 岡村 圭祐; 土川 貴裕; 田本 英司; 中村 透; 倉島 庸; 海老原 裕磨; 野路 武寛; 金井 基錫; 宮崎 大; サシーム・パウデル; 本谷 康二, Japanese Journal of Acute Care Surgery, 4, 2, 195, 195, 2014年09月
  日本Acute Care Surgery学会, 日本語
• 大動脈食道瘻に対する治療戦略
  本谷 康二; 七戸 俊明; サシーム・パウデル; 宮崎 大; 那須 裕也; 市之川 正臣; 福田 直也; 米森 敦也; 金井 基錫; 倉島 庸; 海老原 裕磨; 村上 壮一; 中村 透; 田本 英司; 土川 貴裕; 岡村 圭祐; 平野 聡, Japanese Journal of Acute Care Surgery, 4, 2, 228, 228, 2014年09月
  日本Acute Care Surgery学会, 日本語
• 腹腔鏡下膵体尾部切除を施行した膵ガストリノーマの1例
  横山 啓介; 海老原 裕磨; サシーム・パウデル; 野口 美紗; 高野 博信; 芦立 嘉智; 佐藤 暢人; 蔵前 太郎; 松村 祥幸; 村上 壮一; 田本 英司; 倉島 庸; 中村 透; 松本 譲; 土川 貴裕; 田中 栄一; 七戸 俊明; 平野 聡, 日本臨床外科学会雑誌, 75, 9, 2642, 2642, 2014年09月
  日本臨床外科学会, 日本語
• 内視鏡外科手術の発展のために今できること
  七戸 俊明; 倉島 庸; 海老原 裕磨; 村上 壮一; 宮崎 大; Poudel Saseem; 松本 譲; 土川 貴裕; 岡村 圭祐; 平野 聡, 日本消化器外科学会総会, 69回, O, 29, 2014年07月
  (一社)日本消化器外科学会, 日本語
• 各領域における最良のトレーニングシステムを示す 腹腔鏡下鼠径ヘルニア修復術に対する教育的技能評価及びフィードバックを目的としたチェックリストの開発
  サシーム・パウデル; 倉島 庸; 川原田 陽; 宮崎 恭介; 加藤 弘明; 村上 慶洋; 蔵前 太郎; 海老原 裕磨; 村上 壮一; 田中 栄一; 七戸 俊明; 平野 聡, 日本内視鏡外科学会雑誌, 18, 7, 332, 332, 2013年11月
  (一社)日本内視鏡外科学会, 日本語
• 腹腔鏡下膵切除術における膵切離法の工夫とそのエビデンスを問う 腹腔鏡下尾側膵切除術における術後膵液漏の検討
  村上 壮一; 田中 栄一; 七戸 俊明; 海老原 裕磨; 倉島 庸; 蔵前 太郎; 松村 祥幸; 宮崎 大; サシーム・パウデル; 野口 美紗; 高橋 瑞奈; 平野 聡, 日本内視鏡外科学会雑誌, 18, 7, 372, 372, 2013年11月
  (一社)日本内視鏡外科学会, 日本語
• 【名手が勧めるエネルギーデバイスの使い方とコツ】 単孔式手術、LECSにおけるエネルギーデバイスの使い方とコツ
  渡邊 祐介; 奥芝 俊一; 北城 秀司; 川原田 陽; 川田 将也; 鈴木 善法; 佐々木 剛志; 小野田 貴信; 才川 大介; サシーム・パウデル; 住吉 徹哉; 近藤 仁; 七戸 俊明; 平野 聡; 加藤 紘之, 消化器外科, 35, 4, 473, 484, 2012年04月
  (株)へるす出版, 日本語
• PS-127-5 胃癌根治術Roux-en-Y再建後の内ヘルニア症例の検討(PS-127 胃 合併症,ポスターセッション第112回日本外科学会定期学術集会)
  才川 大介; 川原田 陽; 海老原 裕磨; パウデルサシーム; 小野田 貴信; 佐々木 剛志; 川田 将也; 大久保 智之; 奥芝 俊一; 加藤 紘之, 日本外科学会雑誌, 113, 2, 746, 746, 2012年03月05日
  一般社団法人日本外科学会, 日本語

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  2021年04月01日 - 2024年03月31日
  村上 雅一; 家入 里志; 大西 峻; 倉島 庸; 加治 建; 山田 耕嗣; パウデル サシーム
  現在、株式会社京都科学と連携し、10kgの幼児の骨盤部および体幹部をモデルとした内視鏡外科手術シミュレータを開発中である。3Dスキャナーを使用し、10kgの幼児の気腹した状態の腹部をスキャンし、データを基に京都科学とともにシミュレータのCADデータを作成している。合わせて、本シミュレータで小児内視鏡外科手術の骨盤内での術式を複数トレーニングが行えるように、内容する臓器モデル等についても検討を行っている。
  テレシミュレーション教育を行う予定であるネパールのネパール医科大学小児外科およびトリブバン大学小児外科と連絡を取り合い、ZOOMを使用したテレシミュレーション教育の方法について、検討を行っている。
  本研究に先立ち行ったネパールでの小児内視鏡外科手術のニーズアセスメント調査に関する報告は、国際小児内視鏡外科学会の機関紙であるJournal of Laparoendoscopic & Advanced Surgical Techniques誌に掲載され、Global Surgery領域における日本発による初の論文となった。
  日本学術振興会, 基盤研究(C), 鹿児島大学, 21K12754
• 手術トレーニングおよびナビゲーションへ向けた術中意思決定情報分析
  科学研究費助成事業
  2021年04月01日 - 2024年03月31日
  倉島 庸; 平野 聡; 七戸 俊明; 渡邊 祐介; パウデル サシーム
  外科治療の中心となる手術が高難度になるにつれ、執刀医に求められる技能は手先のテクニックではなく、術中判断力・意思決定能力を含めたノンテクニカルスキルとなる。しかし、過去の外科教育分野における研究は、手術手技のみの正確さや自立性に着目した検討が大多数であり、ノンテクニカルスキルに着目し外科医の思考プロセスを研究した報告はわずかである。そこで、本研究では手術中の外科医の意思決定内容、意思決定能力を分析し、実際の手術成績との相関を検討することを目的とした。実際には以下の1)-3)の目的を中心とした研究が進行中である。
  １）外科医の術中意思決定能力を分析し、レベルの異なる術者間の能力差比較
  ２）外科医の術中意思決定能力と手術パフォーマンスおよび手術成績との相関検討
  ３）外科医の術中意思決定情報を言語ライブラリ化及び手術教育教材開発
  令和3年度の研究計画では「術中意思決定情報分析必要項目の設定」であった。具体的には腹腔鏡下手術の手順を分析し、各術式の重要局面において必要とされる意思決定事項を定義することを目的とした。そこで先行研究として腹腔鏡下幽門側胃切除術技能評価スケール:JORS-LDG (Kurashima Y, et al. Surg Endosc 2019)を使用し、様々なレベルの消化器外科医の腹腔鏡下幽門側胃切除術54例の技能評価を行った。その結果、手術技能と術者の経験数及び短期手術成績との相関を認めた。さらに、サブ解析において、手術全体の工程のうち、幽門下リンパ節郭清の領域が最も術者の技能を反映している可能性が示唆された。これらの結果は令和３年に開催された第34回日本内視鏡外科学会で報告された。
  日本学術振興会, 基盤研究(C), 北海道大学, 21K02795
• ニーズアセスメントにより国際格差を是正する小児内視鏡外科プログラム開発と世界展開
  科学研究費助成事業
  2020年04月01日 - 2023年03月31日
  川野 孝文; 家入 里志; 大西 峻; 矢野 圭輔; 倉島 庸; 春松 敏夫; 山田 耕嗣; パウデル サシーム
  ネパール医科大学小児外科（ネパール連邦民主共和国）およびネパール小児外科学会と共同で、我々の研究グループがこれまでに開発した内視鏡外科手術トレーニングのシミュレータのノウハウを用いて、低中所得国におけるニーズを評価し、内視鏡外科医を育成するプログラムを作成することを目的とする。
  【具体的内容】ネパール小児外科医の内視鏡手術に対する意識調査およびニーズアセスメントを行った。COVID-19の影響で２０２０年度には現地に赴くことはできていないが、Ｓｋｙｐｅでのミーティングを重ねている。２０１９年度に現地で行ったハンズオンセミナーにおいて得られたニーズアセスメントのアンケートの検討を行い、現地の外科医が何を求めているか、何が障壁になり得るかを洗い出している。
  【意義】世界では現在、50億人が必要な時に外科医療にアクセスできない状況であり、外傷、出産、デブリードマンの必要な感染創など、外科医療を提供できる環境では治療可能な疾患で命を落としている。外科医療の世界的な不均衡の是正は21世紀における公衆衛生の重要な目標の一つであり、Lancet Commissionは最重要必要事項として「外科医の育成」を上げている。外科医の育成は各国にとって急務であり、Global Surgeryは世界各国で盛んに研究が行われている分野に発展しているが、残念ながら日本からの報告はほとんどない。
  【重要性】国際的な外科医療の地域間格差を解決するためには、外科医の育成が急務である。そのなかでも内視鏡外科手術に精通した外科医の育成は、低中所得地域がはらむ様々な問題を解決する可能性が高いと考えられる。我々の研究グループが開発した内視鏡外科トレーニングのシミュレータを用いて内視鏡外科医を育成することで、外科医療における地域間格差を是正するための一助になり得る。
  日本学術振興会, 基盤研究(C), 鹿児島大学, 20K10403
• 内視鏡外科修練に関する全国サーベイおよび修練プログラムモデルの開発
  科学研究費助成事業
  2018年04月01日 - 2021年03月31日
  倉島 庸; 平野 聡; 海老原 裕磨; 七戸 俊明; 村上 壮一; パウデル サシーム; 渡邊 祐介
  平成30年7－8月に実施した内視鏡外科修練に関する全国現状調査では、10年目以下の日本内視鏡外科学会一般外科会員へ参加を依頼し、最終回答数は645（回答率28.1%）であった。調査結果は、大多数の回答者が研修施設内で内視鏡外科基本手技の自己練習を行なっていた。消化器外科8術式に対する執刀経験数と習熟度調査結果では、腹腔鏡下嚢摘出術などの低難易度手術は11～20例で概ね自立できていた一方で、腹腔鏡下直腸・胃切除などは大半が自立できていなかった。これらの結果を踏まえて、内視鏡外科手術修練のための体系的なカリキュラム開発および、それら内視鏡外科教育システムの有用性検討を行なっている。
  日本学術振興会, 基盤研究(C), 北海道大学, 18K09993