New surgical procedures: Can our patients benefit while we learn?

Gates, Elena

doi:10.1016/s0002-9378(97)70348-x

Cited by 86 publications

(50 citation statements)

References 18 publications

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“…The use of fresh human cadavers and live animal models, which are considered to be of high fidelity or reality are very limited due to availability, high costs, potential of transmitting infectious diseases as well as ethical issues [1][2][3] . Thus, lower fidelity or reality simulators comprise inorganic, virtual reality and synthetic bench models 8,10 , which sacrifice realism for lower cost, portability and potential for repetitive use 7,8,10 .…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, ethical issues about teaching and learning on human patients as well as economical concerns, regarding the efficient use of operating room time and resources, results in less time available for teaching and practice fundamental surgical skills for the junior surgical apprentice [1][2][3] .…”

Section: Introductionmentioning

confidence: 99%

“…However, ethical/legal and economical issues in the use of human cadavers, live laboratory animals and virtual reality simulators have prompted the use of numerous bench models made of organic or synthetic materials [1][2][3][7][8][9][10][11] . Most of these bench models are focused to trainees in general surgery, but few bench models are available for cardiothoracic fellows.…”

Section: Introductionmentioning

confidence: 99%

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Cryopreserved tracheal segments: a new tool for bench surgical training in thoracic surgery

Sotres-Vega¹,

Villalba-Caloca²,

Ramirez-Zamora³

et al. 2012

Acta Cir. Bras.

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PURPOSE:To present a new low-cost high fidelity bench model of cryopreserved trachea that can be used to learn surgical skills from medical students to cardiothoracic surgery fellows. METHODS: Ten tracheas were harvested from ten non-trachea related research dogs at the moment of euthanasia. Each trachea was trimmed in six or seven rings segments. They were cryopreserved and stored during 60 days. The day programmed for surgical skills practice, they were thawed to room temperature. RESULTS: Forty segments have been used. After defrosting, all the segments kept their normal anatomic shape and structural integrity. Two incisions were made on every tracheal segment and sutured with running or separate stitches with 5-0 polypropilene. There were no complications such as cartilage ruptures, neither tears on the mucosae, the cartilages nor the membranous posterior membrane. CONCLUSIONS: The cryopreserved trachea is a high fidelity, practical, reproducible, portable, low-cost bench model. It allows cardiothoracic fellows to learn how to handle a trachea, as well as to perfect their surgical and suture abilities before applying them on a real patient's trachea. Key words: Trachea. Cryopreservation. Learning. Dogs. RESUMO OBJETIVO: Apresentar novo modelo de traquéia criopreservada de baixo custo e alta fidelidade que pode ser usado tanto por estudantes de medicina como por cirurgiões cardiotorácicos no aprendizado e desenvolvimento de suas habilidades cirúrgicas. MÉTODOS: Foram coletados amostras de dez traquéias de dez cães utilizados para pesquisa após a eutanásia. Cada segmento de traquéia foi dividida em seis ou sete anéis, criopreservadas e armazenadas durante 60 dias. No dia programado para a prática cirúrgica os segmentos foram descongelados a temperatura ambiente. RESULTADOS: Foram utilizados 40 segmentos no estudo. Após o descongelamento todos os segmentos mantiveram sua forma anatômica e sua integridade estrutural. Foram realizadas duas incisões em cada segmento traqueal que foram suturadas em padrão continuo ou com pontos separados utilizando sutura de polipropileno 5-0. Não houve nenhuma complicação como a ruptura da cartilagem, rasgos na mucosa, cartilagem ou na membrana membranosa posterior. CONCLUSÕES: O modelo de traquéia criopreservada é altamente fidedigno, prático, reproduzível, portátil e de baixo custo. Permite que os cirurgiões cardiotorácicos aprendam como manipular a traquéia, assim como aperfeiçoar suas habilidades cirúrgicas antes de sua aplicação em traquéias de pacientes reais. Descritores: Traquéia. Criopreservação. Aprendizagem. Cães. -Vega A et al. Sotres

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cryopreserved tracheal segments: a new tool for bench surgical training in thoracic surgery

Sotres-Vega¹,

Villalba-Caloca²,

Ramirez-Zamora³

et al. 2012

Acta Cir. Bras.

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“…Ante la aparición de nuevos procedimientos quirúrgicos 55 , siempre se debe enseñar y aprender con seguridad y eficiencia ya que al operar pacientes se considera que la curva de aprendizaje ha llegado a su nivel de competencia.…”

Section: Discussionunclassified

Estudio observacional de habilidades quirúrgicas en residentes

Arribalzaga

Jacovella

2006

Educ. méd.

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Introducción: existen actualmente "agujeros negros" en la transmisión de conocimientos aplicables que obligan a poner atención en los mecanismos de adquisición de destrezas y habilidades. El objetivo es evaluar características cualitativas de las habilidades en 2 tipos de procedimientos técnicos básicos al alcance de un cirujano general. Material y Métodos: estudio preliminar exploratorio observacional prospectivo en un Hospital Universitario consistente en la observación de los pasos de una toracotomía axilar o una dermolipectomía abdominal anterior con neo ombligo. Se analizó la práctica de las operaciones programadas, no discriminando que médicos residentes las habían efectuado. Los datos se medían en una lista de cotejos con una escala tipo Likert modificada de 3 items. Cada paso de la técnica observada era evaluado sin considerar el tiempo de duración de cada maniobra. Los evaluadores eran ajenos al equipo quirúrgico actuante ubicados donde no se los veía (en miradores) para evitar sesgos o maniobras que afectaran la actividad. Se usaron pruebas estadísticas de ANOVA y prueba de t para detectar validez y diferencias en los resultados.Resultados: observada una toracotomía, todos los pasos quirúrgicos fueron evaluados por encima del valor 2 (bueno), sin variaciones en el desarrollo de cada paso ni existir diferencias significativas en la comparación de destrezas. Similares resultados se hallaron en la observación de la otra técnica. Conclusiones: con un sencillo método de observación directa inadvertida por el evaluado con criterios específicos se hizo un diagnóstico de situación demostrando la existencia de habilidades adquiridas en cirujanos en formación durante programas de residencia. Palabras clave: cirugía-enseñanza-residencia -habilidadesevaluaciónIntroduction: Some " black holes" in the knowledge transmission process, suggest to pay attention on the correct way to acquire specific surgical skills. The objective is to evaluate qualitative features of main surgical skills in two basis surgical techniques performed by residents. Material and method: Observational prospective preliminary study in University Hospital, in both thoracotomy and abdominoplasty performed. Through a modified comparison Likert scale, specific maneuvers were evaluated. Observers did not know surgeons identity. Statistical analysis (ANOVA and Student t test) was used to detect results validity and differences. Results: Both surgical techniques obtainded a number 2 value (good), without significant differences between them.

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“…9 Furthermore, the "see one, do one, teach one" philosophy is rapidly becoming dated as it may threaten patient safety. 10 Logbooks are utilized by many subspecialties including anesthesiology. Their popularity is based primarily on their simplicity and feasibility because direct observation is not always possible.…”

Section: Cusum Analysismentioning

confidence: 99%