A qualitative assessment of human cadavers embalmed by Thiel's method used in laparoscopic training for renal resection

Abstract

Human cadaveric tissue is the fundamental substrate for basic anatomic and surgical skills training. A qualitative assessment of the use of human cadavers preserved by Thiel's method for a British Association of Urological Surgeons-approved, advanced laparoscopic renal resection skills training course is described in the present study. Four trainees and four experienced laparoscopic surgeons participated in the course. All participants completed a five-point Likert scale satisfaction questionnaire after their training sessions. The quality of cadaveric tissue and the training session were assessed with particular emphasis placed on the ease of patient positioning, the ease of trocar placement, the preservation of tissue planes, the ease of renal pedicle dissection, and the quality of tissue preservation. All of the participants highly rated the quality of the cadaveric tissue embalmed by Thiel's method (mean scores for quality on the five-point Likert scale were 4.5 and 4.3 by the trainees and experienced laparoscopic surgeons, respectively). All of the steps of laparoscopic renal resection were rated 4.0 or more on the Likert scale by both trainees and faculty members. The initial response rates for using a human cadaver embalmed by Thiel's method as a training tool for laparoscopic nephrectomy showed encouraging results. The performance of a laparoscopic nephrectomy on a human cadaver embalmed by Thiel's method bears close resemblance to real laparoscopic nephrectomy procedures, and thus demonstrates added advantages to the previously reported models.

Comparison of modified thiel embalming and ethanol‐glycerin fixation in an anatomy environment: Potentials and limitations of two complementary techniques

“…However, the financial efforts have to be weighed against the tissue characteristics resulting from the fixation agents. As shown in our study and by others (Thiel, ; Wolff et al, ; Benkhadra et al, ; Pattanshetti and Pattanshetti, ; Jaung et al, ; Hölzle et al, ; Munirama et al, ; Prasad et al, ; Eisma et al, ), Thiel‐fixed donors provide outstanding visual and haptic properties. Our modifications may likely aid saving costs in order to make the Thiel technique available to a broader user group (Benkhadra et al, ).…”

“…The wide range of joint motion allows orthopedic and trauma surgeons to perform interventions under realistic conditions, which is not the case after ethanol and formaldehyde fixation. Thiel fixation is also suitable for training laparoscopic techniques (Pattanshetti and Pattanshetti, ; Prasad et al, ) and ultrasound‐assisted interventions such as biopsies and nerve blocks (Munirama et al, ). Even muscle‐ or skin‐flaps can be accomplished by head and neck (Alberty et al, ), plastic (Wolff et al, ), oral surgeons and implantologists (Hölzle et al, ), since the Thiel fixatives prevent blood clot formation.…”

A pilot study comparing the use of Thiel‐ and formalin‐embalmed cadavers in the teaching of human anatomy

“…Clinical staff who participated in the study considered that TEC are more like patients and are better than FEC for surgical training: a finding similar to Jaung et al (). The views of clinicians supported the use of TEC in a clinical setting as previously reported (Kerckaert et al, ; Wolff et al, ; Eisma et al, ; Guo et al, ; Hölzle et al, ; Prasad Rai et al, ).…”

Human preservation techniques in anatomy: A 21st century medical education perspective

“…It is now over 20 years since Walter Thiel developed a novel preservation method that focused on tissue color preservation that set the basis for a new photographic atlas of practical anatomy (Thiel, ). Several articles describe how well the texture and color is preserved in cadavers embalmed with Thiel technique (Benkhadra et al, ; Guo et al, ; Prasad Rai et al, ; Desroches et al, ). Cadavers embalmed by Thiel technique are preserved for over a year after being taken out of the tank of embalming fluid.…”