The Animal Model in Advanced Laparoscopy Resident Training

Torre, Marco La; Caruso, Carlo

doi:10.1097/sle.0b013e31828b895b

Cited by 23 publications

(27 citation statements)

References 17 publications

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“…Both “FLS” and various equivalent “In Vivo” models have been widely used, as training models in the literature [27], [28], [29], [30], [31]. Systematic training with FLS models and, even with more economical improvised FLS surrogates, was found to shorten the time needed to gain proficiency in some techniques [27], [28].…”

Section: Discussionmentioning

confidence: 99%

Is In-Vivo laparoscopic simulation learning a step forward in the Undergraduate Surgical Education?

Pantelidis

Sideris

Tsoulfas

et al. 2017

Annals of Medicine &Amp; Surgery

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BackgroundEssentials Skills in the Management of Surgical Cases – ESMSC is an International Combined Applied Surgical Science and Wet Lab course addressed at the Undergraduate level. Laparoscopic Skills is a fundamental element of Surgical Education and various Simulation-Based Learning (SBL) models have been endorsed. This study aims to explore if there is any significant difference in delegates' performance depending on whether they completed In Vivo module prior to the equivalent in the laparoscopic simulator.Materials and methods37 Medical Students from various EU countries were divided in 2 groups, and both completed the “Fundamentals in Laparoscopic Surgery” module in the Dry-lab Laparoscopic Simulator as well as the same module “In Vivo” on a swine model. Group A (18 students, 48.6%) completed the “Fundamentals in Laparoscopic Surgery - FLS” module prior to the “In Vivo”, whereas group B completed the “In Vivo” module first. Direct Observation of Procedural Skills (DOPS) were used to assess delegates' performance.ResultsThe mean DOPS scores for the “FLS” and “In Vivo” models were 2.27 ± 0.902 and 2.03 ± 0.833, respectively, and the delegates' performance was not statistically significantly different between them (p = 0.128). There was no statistically significant difference in the scores among different gender, year of study, school and handedness groups. The alteration in the sequence between Dry-lab “FLS” and “In Vivo” modules did not affect the performance in neither the “FLS” nor the “In Vivo” models.ConclusionsThe inexpensive, but low-fidelity “FLS” model could serve an equal alternative Simulation-Based Learning model for the early undergraduate training. Our study demonstrated that high fidelity In Vivo simulation for laparoscopic skills does not affect significantly the improvement in the delegates' performance at the undergraduate level. Further studies should be conducted to identify at which stage of training should high fidelity simulation be introduced.

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Section: Discussionmentioning

confidence: 99%

Is In-Vivo laparoscopic simulation learning a step forward in the Undergraduate Surgical Education?

Pantelidis

Sideris

Tsoulfas

et al. 2017

Annals of Medicine &Amp; Surgery

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“…Swine models have been a useful tool in general digestive laparoscopic surgery [37], urology [38], maxillofacial surgery [39], paediatric surgery [40] and oculoplastics [41] for a long time. There have also been comparative studies that aimed to evaluate the effectiveness of both human cadaveric and pig models.…”

Section: Porcine Modelsmentioning

confidence: 99%

Neurosurgical cadaveric and in vivo large animal training models for cranial and spinal approaches and techniques — a systematic review of the current literature

Morosanu

Nicolae

Moldovan

et al. 2018

Neurol Neurochir Pol.

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Introduction. Due to its high complexity, neurosurgery consists of a demanding learning curve that requires intense training and a deep knowledge of neuroanatomy. Microsurgical skill development can be achieved through various models of simulation, but as human cadaveric models are not always accessible, cadaveric animal models can provide a reliable environment in which to enhance the acquisition of surgical dexterity. The aim of this review was to analyse the current role of animal brains in laboratory training and to assess their correspondence to the procedures performed in humans. Material and methods. A Pubmed literature search was performed to identify all the articles concerning training cranial and spinal techniques on large animal heads. The search terms were 'training model' , and 'neurosurgery' in association with 'animal' , 'sheep' , 'cow' , and 'swine'. The exclusion criteria were articles that were on human brains, experimental fundamental research, or on virtual simulators. Results. The search retrieved 119 articles, of which 25 were relevant to the purpose of this review. Owing to their similar neuroanatomy, bovine, porcine and ovine models prove to be reliable structures in simulating neurosurgical procedures. On bovine skulls, an interhemispheric transcalosal and retrosigmoid approach along with different approaches to the Circle of Willis can be recreated. Ovine model procedures have varied from lumbar discectomies on sheep spines to craniosynostosis surgery, whereas in ex vivo swine models, cadaveric dissections of lateral sulcus, median and posterior fossa have been achieved. Conclusions. Laboratory training models enhance surgical advancements by familiarising trainee surgeons with certain neuroanatomical structures and promoting greater surgical dexterity. The accessibility of animal brains allows trainee surgeons to exercise techniques outside the operating theatre, thus optimising outcomes in human surgical procedures.

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“…Yet, the combination of virtual and box-trainer with the animal model training might shorten the learning curve. La Torre et al[25] showed that the ability and time to knot-tying might be reduced if the surgeon underwent training in the virtual simulator prior to the animal model. More important, if the surgeon is exposed to repetitive animal model training, surgical time and intraoperative complications are reduced and the level of confidence and expertise measured by the global operative assessment of laparoscopic skills (GOALS) are significantly improved.…”

Section: Animal and Cadaver Model Laboratorymentioning

confidence: 99%

Impact of laparoscopic surgery training laboratory on surgeon's performance

Torricelli¹,

Barbosa²,

Marchini³

2016

WJGS

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Minimally invasive surgery has been replacing the open standard technique in several procedures. Similar or even better postoperative outcomes have been described in laparoscopic or robot-assisted procedures when compared to open surgery. Moreover, minimally invasive surgery has been providing less postoperative pain, shorter hospitalization, and thus a faster return to daily activities. However, the learning curve required to obtain laparoscopic expertise has been a barrier in laparoscopic spreading. Laparoscopic surgery training laboratory has been developed to aid surgeons to overcome the challenging learning curve. It may include tutorials, inanimate model skills training (box models and virtual reality simulators), animal laboratory, and operating room observation. Several different laparoscopic courses are available with specific characteristics and goals. Herein, we aim to describe the activities performed in a dry and animal-model training laboratory and to evaluate the impact of different kinds of laparoscopic surgery training courses on surgeon’s performance. Several tasks are performed in dry and animal laboratory to reproduce a real surgery. A short period of training can improve laparoscopic surgical skills, although most of times it is not enough to confer laparoscopic expertise for participants. Nevertheless, this short period of training is able to increase the laparoscopic practice of surgeons in their communities. Full laparoscopic training in medical residence or fellowship programs is the best way of stimulating laparoscopic dissemination.

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The Animal Model in Advanced Laparoscopy Resident Training

Abstract: National Resident Training Programs should take into consideration the present quality of training and attempt to develop alternative methods of training for laparoscopic surgery, such as, the animal model laboratory.

Cited by 23 publications

References 17 publications

Is In-Vivo laparoscopic simulation learning a step forward in the Undergraduate Surgical Education?

Is In-Vivo laparoscopic simulation learning a step forward in the Undergraduate Surgical Education?

Neurosurgical cadaveric and in vivo large animal training models for cranial and spinal approaches and techniques — a systematic review of the current literature

Impact of laparoscopic surgery training laboratory on surgeon's performance

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