TEMAS LIBRES
Cirugía General Educación médica, ética y legales

TITULO: TISSUE BLOCK SIMULATOR FOR LAPAROSCOPIC AND ROBOTIC FOREGUT SURGERY


AUTORES: FRANCISCO SCHLOTTMANN, RUDOLF BUXHOEVEDEN, NICOLÁS A. ROTHOLTZ, MARCO G. PATTI

Nº DE REFERENCIA 14406

TIPO PRESENTACION: Temas Libres

CATEGORIA: Cirugía General

SUBCATEGORIA: Educación médica, ética y legales

RESUMEN DE LA PRESENTACION: 

ANTECEDENTES: The safe adoption of laparoscopic and robotic foregut surgery must maximize relevant training prior to transference to the clinical setting. A significant gap presently exists between virtual reality and box-lap simulators and live surgery. Live animal and cadaver use has significant downsides, including high expenses that make difficult their utilization in low-income countries. 

OBJETIVO: We aimed to develop a high fidelity and economic real tissue simulator that allows for training in foregut operations.

DISEÑO: Descriptive and analytic design

MATERIAL Y METODO: Our foregut surgery model is based on porcine tissue blocks that include lungs, heart, aorta, esophagus, diaphragm, stomach, duodenum, liver and spleen. Tissue is preserved in an alcohol based solution that retains fresh tissue characteristics for several weeks. The tissue block is mounted in a human mannequin and perfused with artificial blood. The anterior abdominal wall is constructed so as to allow for laparoscopic and robotic surgical training. Five expert attending foregut surgeons performed laparoscopic and robotic Heller myotomy, Nissen fundoplication and sleeve gastrectomy on the model. After completing the procedures, face validity was measured by surgeon responses to a questionnaire defining the perceived relationship to real surgery, ranging from really unrealistic to highly realistic.

RESULTADOS: The simulator was rated as highly realistic in terms of operative space, organs size and shape, and instrument usage for all three procedures in both laparoscopic and robotic surgery. In addition, all surgeons felt the model could significantly shorten the learning curve for performing these procedures.

CONCLUSIONES: The results of this study show that our model, based on animal tissue blocks, is economical, easy to use, and offers a very realistic representation of laparoscopic and robotic foregut operations, thus achieving a high level of face validity. This low-cost simulation model will allow training surgeons in laparoscopic and robotic foregut procedures in low-income countries.


 


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