An ex vivo liver training model continuously perfused to simulate bleeding for suture skills involved in laparoscopic liver resection: development and validity

Xiao, Jujiao; Zhong-lin, Cui; Fu, Mingyu; Kong, Xiangxue; Tang, Lei; Wang, Zhanglin; You, Fuyu; Du, Qingfeng; Li, Jianyi

doi:10.1007/s00464-016-4792-2

Cited by 13 publications

(16 citation statements)

References 33 publications

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“…To our knowledge, no existing simulator of adverse events during laparoscopic interventions has been described previously, except for wet lab simulators. These simulators consisted of a mock organ perfused with liquid that leaks in the event of injury, and are used to train for hemorrhage control [20,21].…”

Section: Discussionmentioning

confidence: 99%

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Enhanced Laparoscopic Vision Improves Detection of Intraoperative Adverse Events During Laparoscopy

Trilling

Vijayan

Goupil

et al. 2022

IRBM

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Background: The absence of visibility of the entire surgical scene in laparoscopic surgery can lead to unforeseen intraoperative complications. An Enhanced Laparoscopy Vision System (ELViS) was developed to eliminate the blind spots of the traditional endoscope by providing a broad view of the surgical scene from a distance, thanks to two additional images. This study assessed whether the broad view provided by the Enhanced Laparoscopic Vision (ELV) helped the surgeon to detect and react to an unexpected intraoperative adverse event (simulated hemorrhage) occurring while performing a standard task.Methods: While participants were performing a standard task (sorting pins) on a dry lab laparoscopic simulator with or without ELV, a simulated bleeding (LED lighting) was randomly triggered. Perprocedure metrics were recorded and surgeons' feedback gathered at the end of the session.Results: Thirteen Senior surgeons participated. Mean response time was significantly reduced when using ELV, with a similar number of simulated bleeding events between both modalities. All surgeons agreed that ELV could be helpful and constitutes an acceptable increase in cognitive load. Conclusion:In a dry lab setup, compared to traditional endoscopy, the broader field of view provided by ELV improved outcomes when dealing with unforeseen complications like bleeding.

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Section: Discussionmentioning

confidence: 99%

“…These trainers are designed to be easy to transport or store (cubic shape) but in no case represent the dimensions of an inflated abdomen in real surgeries. Wet benches simulating hemorrhage were an alternative that we considered, but the available models [20,21] did not seem easy to implement.…”

Section: Abdominal Training Test Benchmentioning

confidence: 99%

Enhanced Laparoscopic Vision Improves Detection of Intraoperative Adverse Events During Laparoscopy

Trilling

Vijayan

Goupil

et al. 2022

IRBM

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“…The surgeon’s hand movement is affected by the “pivot effect” under laparoscopy, which also increases the difficulty of laparoscopic operations [ 14 ]. In addition, finding the wound that needs stitching is done with the assistance of moving lens, which requires time and coordination; therefore, it is difficult to locate the wound and use the needle to suture a series of stitches quickly [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Application of multidirectional stitching technology in a laparoscopic suturing instructional program: a randomized controlled trial

Zhao

Chen

et al. 2020

BMC Med Educ

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Background: Surgeon suturing technology plays a pivotal role in patient recovery after laparoscopic surgery. Intracorporal suturing and knot tying in minimally invasive surgery are particularly challenging and represent a key skill for advanced procedures. In this study, we compared the application of multidirectional stitching technology with application of the traditional method in a laparoscopic suturing instructional program. Methods: We selected forty residents within two years of graduation to assess the specialized teaching of laparoscopic suturing with laparoscopic simulators. The forty students were randomly divided into two groups, a control group and an experimental group, with twenty students in each group. The control group was scheduled to learn the traditional suture method, and the experimental group applied multidirectional stitching technology. The grades for suturing time, thread length, accuracy of needle entry, stability of the knot, tissue integrity, and tightness of the tissue before and after the training program were calculated. Results: There was no significant difference between the two groups before the learning intervention. After the program, both groups significantly improved in each subject. There were significant differences between the control group and the experimental group in suture time (P = 0.001), accuracy of needle entry and exit (P = 0.035), and whether the suture tissue had cracks (P = 0.030). However, the two groups showed non-significant differences in thread length (P = 0.093), stablity of the knot (P = 0.241), or tightness of the tissue (P = 0.367). Conclusions: Multidirectional stitching technology improves the efficiency and effectiveness of traditional laparoscopic suture instructional programs. It might be a practicable, novel training method for acquiring proficiency in manual laparoscopic skills in a training setting.

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“…; Xiao et al. ). Ex vivo anatomical studies allow the injection of a permanent mixture, including casting techniques (Bergeron et al.…”

Section: Introductionmentioning

confidence: 98%

“…) and liver resection (Xiao et al. ). Currently, magnetic resonance imaging (MRI) and computed tomography (CT) are the accepted diagnostic tools in angiography, largely used in preoperative studies, but also for teaching methods, postmortem anatomic, pathologic, and forensic diagnoses, since colored fixated vessel system actually helps in pathological or forensic diagnosis (Grabherr et al.…”

Section: Introductionmentioning

confidence: 99%

A guide for effective anatomical vascularization studies: useful ex vivo methods for both CT and MRI imaging before dissection

et al. 2017

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The objective of this study was to develop a simple and useful injection protocol for imaging cadaveric vascularization and dissection. Mixtures of contrast agent and cast product should provide adequate contrast for two types of ex vivo imaging (MRI and CT) and should harden to allow gross dissection of the injected structures. We tested the most popular contrast agents and cast products, and selected the optimal mixture composition based on their availability and ease of use. All mixtures were first tested in vitro to adjust dilution parameters of each contrast agent and to fine-tune MR imaging acquisition sequences. Mixtures were then injected in 24 pig livers and one human pancreas for MR and computed tomography (CT) imaging before anatomical dissection. Colorized latex, gadobutrol and barite mixture met the above objective. Mixtures composed of copper sulfate (CuSO 4 ) gadoxetic acid (for MRI) and iodine (for CT) gave an inhomogeneous signal or extravasation of the contrast agent. Agar did not harden sufficiently for gross dissection but appears useful for CT and magnetic resonance imaging (MRI) studies without dissection. Silicone was very hard to inject but achieved the goals of the study. Resin is particularly difficult to use but could replace latex as an alternative for corrosion instead of dissection. This injection protocol allows CT and MRI images to be obtained of cadaveric vascularization and anatomical casts in the same anatomic specimen. Post-imaging processing software allow easy 3D reconstruction of complex anatomical structures using this technique. Applications are numerous, e.g. surgical training, teaching methods, postmortem anatomic studies, pathologic studies, and forensic diagnoses.

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An ex vivo liver training model continuously perfused to simulate bleeding for suture skills involved in laparoscopic liver resection: development and validity

Abstract: CPTM offers trainees a highly simulated-bleeding means to acquire advanced laparoscopic suture skills. The suture skills learned on CPTMs may improve significantly at the seventh round.

Cited by 13 publications

References 33 publications

Enhanced Laparoscopic Vision Improves Detection of Intraoperative Adverse Events During Laparoscopy

Enhanced Laparoscopic Vision Improves Detection of Intraoperative Adverse Events During Laparoscopy

Application of multidirectional stitching technology in a laparoscopic suturing instructional program: a randomized controlled trial

A guide for effective anatomical vascularization studies: useful ex vivo methods for both CT and MRI imaging before dissection

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