Novel laparoscopic training system with continuously perfused ex-vivo porcine liver for hepatobiliary surgery

Liu, Wenyan; Zheng, Xinglong; Wu, Rongqian; Jin, Yinbin; Kong, Sue; Li, Jianpeng; Lu, Jianwen; Yang, Huan; Xu, Xianghua; Lv, Yi; Zhang, Xiaogang

doi:10.1007/s00464-017-5731-6

Cited by 16 publications

(10 citation statements)

References 16 publications

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“…Recently, Liu et al . reported a novel laparoscopic simulation model involving a porcine liver that was continuously perfused, and observed skill improvements in laparoscopic cholecystectomy in 43 participants during their simulation training 20 . Compared with these cadaveric models, we consider our model to be a generic training model for young trainees to learn a broad range of essential skills in laparoscopic surgery, including grasping tissue, tissue traction and dissection, applying a Hem‐o‐lok clip, and suturing/knotting, as aforementioned.…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a porcine organ model for training in essential laparoscopic surgical skills

et al. 2020

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Objectives: To develop a wet laboratory training model for learning core laparoscopic surgical skills and evaluating learners' competency level outside the operating room. Methods: Participants completed three tasks (task 1: tissue dissection around the aorta; task 2: tissue dissection and division of the renal artery; task 3: renal parenchymal closure). Each performance was video recorded and subsequently evaluated by two experts, according to the Global Operative Assessment of Laparoscopic Skills and taskspecific metrics that we developed (Assessment Sheet of Laparoscopic Skills in Wet Lab score). Mean scores were used for analyses. The subjective mental workload was also assessed (NASA Task Load Index). Results: The 54 participants included 32 urologists, eight young trainees and 14 medical students. A total of 13 participants were categorized as experts (≥50 laparoscopic surgeries), eight as intermediates (10-49) and 33 as novices (0-9). There were significant differences in the Global Operative Assessment of Laparoscopic Skills and Assessment Sheet of Laparoscopic Skills in Wet Lab scores among the three groups in all three tasks. Higher NASA Task Load Index scores were observed in novices, and there were significant differences in tasks 1 (Kruskal-Wallis test, P = 0.0004) and 2 (P = 0.0002), and marginal differences in task 3 (P = 0.0745) among the three groups. Conclusions: Our training model has good construct validity, and differences in the NASA Task Load Index score reflect previous laparoscopic surgical experiences. Our findings show the ability to assess both laparoscopic surgical skills and mental workloads, which could help educators comprehend trainees' level outside the operating room. Given the decreasing opportunity to carry out pure laparoscopic surgeries because of the dissemination of robotic surgery, especially in urology, our model can offer practical training opportunities.

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Section: Discussionmentioning

confidence: 99%

Development and validation of a porcine organ model for training in essential laparoscopic surgical skills

et al. 2020

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“…A laparoscopy training platform [11] was used for the ex vivo test and a porcine liver was placed in the platform for the cholangiography model. A 20-Fr T-tube was inserted into the common bile duct and fixed with 1-0 silk.…”

Section: Methodsmentioning

confidence: 99%

A Novel Remote-Controlled Injection Device for T-Tube Cholangiography: A Feasibility Study in Canines

et al. 2019

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BackgrounThe purpose of this study was to develop a remote-controlled injection device for T-tube cholangiography to avoid occupational exposure.Material/MethodsThe remote-controlled injection device has 3 major components: an injection pump, a pressure sensor, and a wireless remote-control panel. The feasibility and effectiveness of this device for T-tube cholangiography was evaluated in ex vivo porcine livers using a laparoscopic training platform and in in vivo canine experiments.ResultsThe contrast dye was successfully injected into the biliary tracts of the ex vivo porcine liver and canines by the designed device. The X-ray images clearly showed the anatomical structure of the bile ducts. No obvious adverse reaction was observed in the dogs during or after the procedure. All steps were controlled remotely, avoiding ionizing radiation exposure to the surgeons.ConclusionsThis novel remote-controlled injection device for T-tube cholangiography can assist operators in completing cholangiography remotely and protecting them from occupational exposure.

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“…Advanced laparoscopy training currently includes box-trainers [4], virtual reality training [5], live animal training [6] and training that combines all of the above [7]. Unfortunately, the majority of training modalities in laparoscopy concentrate on purely technical knowledge not considering psychological burden of a major intraoperative disaster.…”

Section: Contrary To Traditional Approach Suggesting Immediate Conversionmentioning

confidence: 99%

"Simulation of a Laparoscopic Major Vessel Injury in a Live Animal Model"

Potapov

2021

BJSTR

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Objective: Iatrogenic injury to major vessels is a rare but potentially life-threatening complication during laparoscopic hepato-pancreato-biliary surgery. This experimental study aimed to assess the usefulness of an in-vivo animal model for the management of such injuries.Methods: During three editions of advanced live animal laparoscopy courses 12 participants were exposed to 19 intraoperative iatrogenic vessel injuries. The participants were free to control the bleeding using maneuvers of their choice. The participants' heart rate was measured, and their movements were video recorded. The study was evaluated by all participants using a Visual Analogue Scale at the end of the course.Results: Temporary vessel control was obtained in all cases. One animal died due to relapse of bleeding. Heart rate (HR) of participants ranged from 52 to 97 per minute before the task and from 75 to 120 per minute during the task. Eleven participants gave this exercise a 5/5 score and one gave it a score of 3/5. The HR was higher in experienced surgeons vs. inexperienced residents although this difference did not reach statistical significance. Conclusion:In-vivo pig and sheep model can be used for training in major bleeding control during HPB surgery. It is highly appreciated by trainees. It seems that stress level during advanced exercises is higher in experienced surgeons than in beginners.

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Novel laparoscopic training system with continuously perfused ex-vivo porcine liver for hepatobiliary surgery

Abstract: Real-Liver Laptrainer is a feasible, stable, and practical training model that has potential for improving the laparoscopic skills of surgeons.

Cited by 16 publications

References 16 publications

Development and validation of a porcine organ model for training in essential laparoscopic surgical skills

Development and validation of a porcine organ model for training in essential laparoscopic surgical skills

A Novel Remote-Controlled Injection Device for T-Tube Cholangiography: A Feasibility Study in Canines

"Simulation of a Laparoscopic Major Vessel Injury in a Live Animal Model"

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