Taylor John D, Hammond Ian G
Department of Urology and Urogynaecology, King Edward Memorial Hospital for Women, Subiaco, Western Australia, Australia.
Aust N Z J Obstet Gynaecol. 2004 Apr;44(2):146-8. doi: 10.1111/j.1479-828X.2004.00219.x.
Surgical training in gynaecological oncology is complex and alternatives to the 'apprenticeship' model are being explored. Animate and inanimate simulation may be useful, allowing trainees to gain experience without the risk of harm to patients. Live animal models and ex vivo isolated material is commonly used. We present the use of a freshly killed pig (FKP) for training in the urological and gastrointestinal surgery pertinent to gynaecological oncology.
An Anatomy of Complications Workshop was held for 12 specialists and subspecialty Trainees in gynaecological oncology. Seven freshly killed pigs were used for surgical training in a range of urological and intestinal operations including repair of a transected ureter, ureteric reimplantation, Boari flap, ileal conduit, bowel resection and anastomosis and stoma formation. A pre-workshop instructional video was sent to all participants. A live demonstration of each procedure preceded the participant's own closely supervised performance.
All participants completed the procedures in the allocated time. The tissues felt 'live' throughout the 4 h session and were kept moist with a fine water spray. The use of sutures, ligatures and stapling instruments felt realistic. Formal participant feedback evaluation was enthusiastic about the FKP model.
We have demonstrated that the FKP can be successfully used for training in urological and gastrointestinal procedures. The range of operations described in the present paper could be expanded for other surgical disciplines. This simulation is recommended to Trainees as a valuable addition to their training and development.
妇科肿瘤学的外科培训很复杂，人们正在探索“学徒制”模式的替代方案。动画和实物模拟可能会有所帮助，能让学员在不伤害患者的情况下积累经验。活体动物模型和离体材料是常用的。我们展示了使用刚宰杀的猪（FKP）进行与妇科肿瘤学相关的泌尿外科和胃肠外科手术培训。
为12名妇科肿瘤学专家和专科培训学员举办了一次并发症解剖研讨会。使用了7头刚宰杀的猪进行一系列泌尿外科和肠道手术的培训，包括横断输尿管修复、输尿管再植、鲍里皮瓣术、回肠代膀胱术、肠切除吻合术和造口术。会前向所有参与者发送了教学视频。在参与者亲自操作并得到密切监督之前，先进行了每个手术的现场演示。
所有参与者都在规定时间内完成了手术。在整个4小时的课程中，组织感觉像是“活的”，并用细水雾保持湿润。使用缝线、结扎线和吻合器的感觉很真实。参与者的正式反馈评价对FKP模型很满意。
我们已经证明FKP可成功用于泌尿外科和胃肠手术的培训。本文所述的手术范围可扩展到其他外科领域。建议将这种模拟作为学员培训和发展的宝贵补充。
