Validation of newly developed physical laparoscopy simulator in transabdominal preperitoneal (TAPP) inguinal hernia repair

Nishihara, Yuichi; Isobe, Yoh; Kitagawa, Yuukou

doi:10.1007/s00464-017-5614-x

Cited by 21 publications

(14 citation statements)

References 19 publications

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“…With the recent development of three-dimensional modeling technology, it has become possible to create models to use for training in complex procedures. [11] [12] [13] We used this technology to develop training models for PJ. These models reproduce human anatomy with great accuracy to facilitate PJ training.…”

Section: Discussionmentioning

confidence: 99%

A Structured Program for Teaching Pancreatojejunostomy Outside the Operating Room

Oshiro¹,

Endo²,

Morishima³

et al. 2020

Preprint

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Background: Pancreatojejunostomy (PJ) is one of the most difficult and challenging abdominal surgical procedures. Most trainees learn this procedure in the operating room (OR) because there are no appropriate training systems available outside the OR. This extends the learning curve and may affect patient safety. We developed a structured program for teaching PJ to increase training opportunities outside the OR. Methods: We have created this structured program to help trainees acquire both didactic knowledge and technical skills to perform PJ. A manual was created to provide general knowledge about PJ and the specific PJ procedure used in our institution. Based on questionnaires completed by trainers and trainees, the procedure for PJ was divided into twelve steps and described in detail. After creating the manual, we developed organ models, needles and a frame box for simulation training.Results: Trainees learn about PJ by reading the procedure manual, acquiring both general and specific knowledge. We conducted simulation training outside the OR using the training materials created for this system. Training was performed with participants referring to the procedure manual while performing the simulation training. They simulate the procedure with surgical instruments as both primary and assistant surgeon. After finishing the anastomosis, trainees inspect the resulting structures from all angles including the posterior side and intraluminally, which cannot be observed during the actual operation. Conclusion: We developed a structured program for teaching PJ. By implementing this program, it is expected that a trainee’s learning curve will be shortened while ensuring patient safety.

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Section: Discussionmentioning

confidence: 99%

A Structured Program for Teaching Pancreatojejunostomy Outside the Operating Room

Oshiro¹,

Endo²,

Morishima³

et al. 2020

Preprint

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show abstract

“…However, as the majority (79%) of participants had performed < 10 or no TAPP repair for inguinal hernias before, this assessment may not be reliable. Nishihara et al developed a 3D-printed physical laparoscopy simulator and handmade organ replica to simulate trans-abdominal pre-peritoneal inguinal hernia repair [18]. This model was later evaluated, and demonstrated to show construct validity [19].…”

Section: Totally Extra-peritoneal (Tep) Inguinal Hernia Repairmentioning

confidence: 99%

Characteristics of laparoscopic and open hernia repair simulation models: a systematic review

Pelly

Vance-Daniel

Linder

2021

Hernia

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Purpose Barriers to education in open and laparoscopic hernia repair technique include a steep learning curve and reduced theatre time for junior surgical trainees. This is particularly evident during the current COVID-19 pandemic. Simulation models may provide further opportunities for training in hernia repair outside of the traditional surgical apprenticeship model. Methods A systematic review was carried out following PRISMA guidelines to identify and evaluate simulation models in hernia repair. Of the 866 records screened, 27 were included in the analysis. These were assessed for face, content and construct validity, as well as their attempt to measure educational impact. Results Simulation models were identified comprising of animal tissues, synthetic materials and virtual reality (VR) technology. Models were designed for instruction in repair of inguinal, umbilical, incisional and diaphragmatic hernias. Twenty-one laparoscopic hernia repair models were described. Many models demonstrated validity across several domains, and three showed transferability of skills from simulation to the operating room. Of the six open hernia repair simulation models, none were found to have demonstrated an educational impact in addition to assessing validity. Conclusion Few models individually were able to demonstrate validity and educational impact. Several novel assessment tools have been developed for assessment of progress when performing simulated and real laparoscopic inguinal hernia repair. More study is required, particularly for open hernia repair, including randomized controlled trials with large sample sizes to assess the transferability of skills.

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“…It allows the trainee to train repeatedly in a uniform environment without ethical issues. With the recent development of three-dimensional modeling technology, it is possible to create models to use for training complex procedures [13][14][15]. We used this technology to develop the training models for PJ.…”

Section: Subjective Evaluationmentioning

confidence: 99%

A structured program for teaching pancreatojejunostomy to surgical residents and fellows outside the operating room: a pilot study

et al. 2021

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Background Pancreatojejunostomy (PJ) is one of the most difficult and challenging abdominal surgical procedures. There are no appropriate training systems available outside the operating room (OR). We developed a structured program for teaching PJ outside the OR. We describe its development and results of a pilot study. Methods We have created this structured program to help surgical residents and fellows acquire both didactic knowledge and technical skills to perform PJ. A manual was created to provide general knowledge about PJ and the specific PJ procedure used in our institution. Based on questionnaires completed by trainers and trainees, the procedure for PJ was divided into twelve steps and described in detail. After creating the manual, we developed organ models, needles and a frame box for simulation training. Three residents (PGY3-5) and three fellows (PGY6 or above) participated in a pilot study. Objective and subjective evaluations were performed. Results Trainees learn about PJ by reading the procedure manual, acquiring both general and specific knowledge. We conducted simulation training outside the OR using the training materials created for this system. They simulate the procedure with surgical instruments as both primary and assistant surgeon. In this pilot study, as objective assessments, the fellow-group took less time to complete one anastomosis (36 min vs 48 min) and had higher scores in the objective structured assessment of technical skill (average score: 4.1 vs 2.0) compared to the resident-group. As a subjective assessment, the confidence to perform a PJ anastomosis increased after simulation training (from 1.6 to 2.6). Participants considered that this structured teaching program is useful. Conclusion We developed a structured program for teaching PJ. By implementing this program, learning opportunities for surgical residents and fellows can be increased as a complement to training in the OR.

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Validation of newly developed physical laparoscopy simulator in transabdominal preperitoneal (TAPP) inguinal hernia repair

Cited by 21 publications

References 19 publications

A Structured Program for Teaching Pancreatojejunostomy Outside the Operating Room

A Structured Program for Teaching Pancreatojejunostomy Outside the Operating Room

Characteristics of laparoscopic and open hernia repair simulation models: a systematic review

A structured program for teaching pancreatojejunostomy to surgical residents and fellows outside the operating room: a pilot study

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