The Methodist Hospital, Weill Cornell Medical College, Houston, TX, USA.
Surg Endosc. 2013 Jun;27(6):1953-6. doi: 10.1007/s00464-012-2693-6. Epub 2013 Jan 26.
Minimally invasive components separation (MICS) is believed to decrease wound complications by reducing local tissue damage and eliminating the interruption of blood supply to the overlying skin and soft tissue. One drawback to the MICS technique is the difficulty with identifying the correct location for entry into the anterior abdominal wall. We believe that ultrasound can be used to visually assist identification of the correct surgical entry site (the avascular space between the external and internal abdominal oblique muscles, lateral to the linea semilunaris).
The purpose of this study was to assess if novices can readily learn an ultrasound technique for identifying abdominal wall myofascial components via a video education tool.
This research was an institutional review board-approved, prospective, observational study. Ten surgical residents were asked to watch a 1-min training video containing basic instructions on ultrasound technique for identifying the myofascial anatomy of the anterior abdominal wall. After watching the educational video, the subjects were asked to identify the linea semilunaris first by external anatomy, then by ultrasound. A grader, blinded to the identification of the subject, recorded if the subject correctly identified the location of the linea semilunaris by each method (external anatomy only versus ultrasound guided).
Ten subjects were evaluated. Nine of ten (90 %) subjects correctly identified the linea semilunaris with ultrasound. Only three of ten (30 %) subjects correctly identified the linea semilunaris by physical exam.
Ultrasound technology can aid in identification of the abdominal wall musculofascial units in MICS and be easily taught via short video instruction to novices with excellent results. Further studies will be necessary to prove that ultrasound use can decrease complications associated with entry into the appropriate avascular space between the external and internal abdominal oblique muscles, lateral to the linea semilunaris.
微创组件分离（MICS）被认为通过减少局部组织损伤并消除对覆盖皮肤和软组织的血液供应的中断来减少伤口并发症。MICS 技术的一个缺点是难以确定进入前腹壁的正确位置。我们相信超声可以用于直观地协助识别正确的手术进入部位（腹外斜肌和腹内斜肌之间的无血管空间，侧至半月线）。
本研究旨在评估新手是否可以通过视频教育工具轻松学习用于识别腹壁肌筋膜组件的超声技术。
这是一项机构审查委员会批准的、前瞻性、观察性研究。要求 10 名外科住院医师观看包含识别前腹壁肌筋膜解剖结构的超声技术基本说明的 1 分钟培训视频。观看教育视频后，要求受试者首先通过外部解剖结构，然后通过超声识别半月线。一位对受试者身份识别不知情的评分者记录了受试者是否通过每种方法（仅外部解剖结构与超声引导）正确识别了半月线的位置。
评估了 10 名受试者。10 名受试者中有 9 名（90%）通过超声正确识别了半月线。仅 10 名受试者中的 3 名（30%）通过体格检查正确识别了半月线。
超声技术可帮助识别 MICS 中的腹壁肌肉筋膜单位，并可通过简短的视频教学轻松教授给新手，效果极佳。需要进一步的研究来证明超声的使用可以减少与进入腹外斜肌和腹内斜肌之间适当无血管空间相关的并发症，位于半月线的外侧。
