The role of wet lab in thoracic surgery

Abstract

During the last three decades, minimally invasive surgery has become common practice in all kinds of surgical disciplines and, in Thoracic Surgery, the minimally invasive approach is recommended as the treatment of choice for early-stage non-small cell lung cancer. Nevertheless, all over the world a large number of lobectomies is still performed by conventional open thoracotomy and not as video-assisted thoracic surgery (VATS), which shows the need of a proper training for this technique. Development and improvement of surgical skills are not only challenging and time-consuming components of the training curriculum for resident or fellow surgeons, but also for more experienced consultants learning new techniques. The rapid evolution of medical technologies like VATS or robotic surgery requires an evolution of the existing educational models to improve cognitive and procedural skills before reaching the operating room in order to increase patient safety. Nowadays, in the Thoracic Surgery field, there is a wide range of simulation-based training methods for surgeons starting or wanting to improve their learning curve in VATS. Aim is to overcome the learning curve required to successfully master this new technique in a brief time. In general, the basic difference between the various learning techniques is the distinction between "dry" and "wet" lab modules, which mainly reflects the use of synthetic or animal-model-based materials. Wet lab trainings can be further sub-divided into in vivo modules, where living anaesthetized animals are used, and ex vivo modules, where only animal tissues serve as basis of the simulation-based training method. In the literature, the role of wet lab in Thoracic Surgery is still debated. In general, the basic difference between the various learning techniques is the distinction between "dry" and "wet" lab modules, which mainly reflects the use of synthetic or animal-model-based materials (9,10). Wet lab trainings can be further sub-divided into in vivo modules, where living anaesthetized animals are used, and ex vivo modules, where only animal tissues serve as basis of the simulation-based training method. In the literature, the role of wet lab in Thoracic Surgery is still debated. Dry labThe advances in the experience with minimally invasive techniques and the introduction of new instrumentation that needed to be tested in a non-clinical environment and eventually discussed or improved by technicians or bio-medical engineers have led to the evolution of dry laboratories. These working environments are providing simulators such as box trainers and virtual reality (VR) simulators (11). But where laparoscopic surgery has undergone a rapid evolution of the simulation-based training methods for the training and assessment of technical skills in general surgical procedures, the parallel development of models for minimally invasive thoracic surgical procedures has not arisen in the same manner. The reasons behind this are probably multifactorial. Thoracic procedures are less stand...

Evaluation of Short-Term Outcomes and the Learning Curve Wherein a Thoracic Resident Doctor Performed Video-Assisted Thoracoscopic Anatomical Lung Resection for Lung Cancer

“…As a solution to this problem, it has been reported that the creation of video-assisted thoracoscopic lobectomy simulators and training programs, the use of dry or wet labs, and the introduction of virtual-reality technology into these programs are useful in educating thoracic resident doctors. [19][20][21][22][23] In this study, the thoracic resident doctor trained in dry and wet labs before the first surgery. He trained in suturing using models and folding birds with origami paper in the dry lab.…”

The evolution of the contemporary thoracic surgeon: open surgery versus video-assisted thoracic surgery teaching—a clinical practice overview

“…Wet and dry labs provide another step on the learning process because they add to the training scenario the tissues and anatomical relationships between structures (22). Live animals provide excellent training scenarios, although the availability is limited, and there is no opportunity for repetition training as in a simulator, where a trainee is free to perform around 10 procedures in a single training session.…”

Completeness of training in thoracic surgery: the perfect operative log book

“…Dry and wet lab exercises were also found to be useful in VATS training (14). Left sided VATS resections are performed in live pigs.…”