Development and Initial Assessment of a Training Program for Laparoscopic Radical Prostatectomy. First Module: The Urethrovesical Anastomosis

Pérez-Duarte, Francisco J.; Fernández-Tomé, Blanca; Dı́az-Güemes, Idoia; Enciso, Silvia; Matos-Azevedo, Ana Maria; Sánchez-Hurtado, Miguel Ángel; Hernández, Laura Bartolomé; Sánchez‐Margallo, Francisco M.

doi:10.1089/end.2014.0050

Cited by 10 publications

(12 citation statements)

References 33 publications

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“…Rosin et al 16 reported maximal urethral pressure between 25 and 36 mm Hg during urinary pressure profile in a male dogs. It has been shown that leakage pressure increases with the experience of the surgeon 15 . We could not identify a trend related to the experience with the technique in our study.…”

Section: Discussionmentioning

confidence: 55%

“…It requires an appropriate tissue apposition to minimize leakage in the postoperative period and to improve long term outcomes 2,6,11‐14 . During the learning process of LRP in man, mastering VUA is the first step of the training for surgeons 15 . Laparoscopic radical prostatectomy and subsequent VUA have been described with promising outcomes in a canine model, providing evidence of the feasibility of minimally invasive surgery in cases of RP 12 .…”

Section: Introductionmentioning

confidence: 99%

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Comparison of leakage pressures of vesicourethral anastomosis performed with intracorporeal suturing in a simulator and conventional suturing ex vivo in canine cadaveric tissue

2021

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Objective To compare conventional and intracorporeal vesicourethral anastomosis (VUA) in canine cadaveric tissue. Study design Cadaveric ex vivo study. Study population Twenty‐eight canine bladders with urethra. Methods Specimens after prostatectomy were randomly divided into intracorporeal (I) group or conventional (C) group. For the I group, VUA was performed in a simulator with laparoscopic needle holders and telescope. For the C group, the anastomosis was performed in vitro with standard instruments. The VUA was performed with 4–0 monofilament absorbable suture and was completed with two simple continuous sutures. Surgical time, leakage pressure, site of leakage, and number of suture bites were recorded. Results Fourteen samples were entered in each group. The dorsal side of the anastomosis was initially performed, followed by the ventral side. The median suturing time was 30.8 minutes (range, 19.3–39.2) for the I group and 17.3 minutes (range, 9.2–21.3) for the C group (P < .0001). The median leakage pressure was 10.9 mm Hg (range, 4.1–29.7) for the I group and 10.8 mm Hg (range, 6.2–18.5) for the C group (P = .94). The median number of stitches was 20 (range, 14–26) for the I group and 19 (range, 11–28) for the C group (P = .96). The distribution of the site of leakage was similar between groups (P = .381). Conclusion Vesicourethral anastomosis can be performed with leakage pressures similar to intracorporeal and conventional suturing. Clinical significance This study represents the first step toward laparoscopic radical prostatectomy in dogs.

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Section: Discussionmentioning

confidence: 55%

Section: Introductionmentioning

confidence: 99%

Comparison of leakage pressures of vesicourethral anastomosis performed with intracorporeal suturing in a simulator and conventional suturing ex vivo in canine cadaveric tissue

2021

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“…The proposed model is based on concepts seen in other models used for training of many other surgeries and their successful experiences [26][27][28][29][30][31]. The main concept subjective excellent impression considering the satisfaction of trainees and operative results themselves.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous Bilateral Surgery as a Model for Learning Video Endoscopic Inguinal Lymphadenectomy (VEIL)

Tobias¹,

Lima²,

Aurus³

et al. 2017

Adv Laparoscopy

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Purpose: Video Endoscopic Inguinal Lymphadenectomy (VEIL) is feasible and safe in selected patient with groin metastases. Simultaneous bilateral performance seems to improve morbidity, however it still requires standardization. This article aims to describe a standardized and planned training model for VEIL. Materials and methods: This model comprises a standardized training as follows: 1) Oral and video presentation; 2) Two groins operated by the teacher with camera manipulated by trainees; 3) Simultaneous VEIL performed by trainees. Three medical centers tested this model between January and December 2014. Perioperative, functional and oncological data are evaluated. Statistical analysis was done by using arithmetic average and Student T-test. Data were compared among expert, trainees and trained surgeons. Results: Ten groins were operated by trainees and twenty by the same trained surgeons. Demographic characteristics are in accordance with most of the reported studies. Surgical performance and oncological results of trainees and trained surgeons didn't differ significantly from the expert surgeon. Conclusions: Despite the limited number of patients, the proposed model is effective as an option for training in large scale. Potential advantages include feasibility and optimization of operative time.

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“…From the 80's, the art of surgery began an unprecedented process of transformation, with minimally invasive surgery assuming an important role in this scenario. Among its advantages we could mention less postoperative pain, shorter hospital stay, faster return to usual activities, better aesthetic result, significant reduction of overall costs, especially considering the period of retirement from work activities, and a lower rate of infections 1 – 5 .…”

Section: Discussionmentioning

confidence: 99%

Homemade laparoscopic simulator

et al. 2019

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Purpose:To describe a guide for the construction of a laparoscopic training simulator.Methods:Step-by-step description of an inexpensive and easy to assemble homemade laparoscopic training box, capable of simulating the laparoscopic environment in its peculiarities to enable technical skills training.Results:The total cost of the materials for the construction of the simulator was US$ 75.00 (about R$ 250.00 “reais”) and it can be reduced to US$ 60.00 if the builder judges that there is no need for internal lighting. The use of real trocars imposes the same challenges as real surgeries regarding positioning, visibility and limitation of movements.Conclusion:The proposed economical and efficient alternative can contribute to the teaching and practice of laparoscopic surgical technique worldwide, benefiting surgeons and patients.

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Development and Initial Assessment of a Training Program for Laparoscopic Radical Prostatectomy. First Module: The Urethrovesical Anastomosis

Cited by 10 publications

References 33 publications

Comparison of leakage pressures of vesicourethral anastomosis performed with intracorporeal suturing in a simulator and conventional suturing ex vivo in canine cadaveric tissue

Comparison of leakage pressures of vesicourethral anastomosis performed with intracorporeal suturing in a simulator and conventional suturing ex vivo in canine cadaveric tissue

Simultaneous Bilateral Surgery as a Model for Learning Video Endoscopic Inguinal Lymphadenectomy (VEIL)

Homemade laparoscopic simulator

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