Department of Urology, Western Hospital, Melbourne, Victoria, Australia; University of Melbourne, Western Clinical School, Sunshine Campus, Melbourne, Victoria, Australia.
Urology. 2013 Oct;82(4):955-8. doi: 10.1016/j.urology.2013.06.013. Epub 2013 Jul 31.
Suprapubic catheter (SPC) insertion is a basic skill required of surgical trainees. It is likely a trainee's first attempt at the procedure, will be undertaken without direct supervision at night and without access to aids of catheterization. Unfortunately, lack of simulation models and unpredictability of when SPCs are required, make it difficult to acquire this skill. Therefore, junior doctors frequently persist with urethral catheterization, with an increased risk of urethral injury. Improper catheterization has been cited as the causative factor for urethral strictures. The aim of this study was to develop an SPC model and assess its influence on a trainee's confidence in this procedure.
An SPC model needs to fulfill a number of criteria. It should have anatomic characteristics of a bladder and provide realistic visual and sensory feedback. Cost effective copies of the model, which are able to be rapidly cycled through simulations are needed for effective clinical workshops. Finally, a trainee's understanding and confidence in performing the procedure should increase after using it. This prototype model has 3 anatomic parts: the bladder, the anterior abdominal wall, and the housing abdominal box. The most crucial component is the bladder, which is a balloon with Mefix tape that prevents leaking and "popping" on trocar insertion.
This SPC model can be readily replicated by most clinical school and easily added to surgical workshops to ensure that trainees have hands on experience with this procedure before being required to perform it on patients.
耻骨上导管（SPC）插入术是外科受训者所需的基本技能。这可能是受训者第一次尝试该程序，将在夜间没有直接监督且无法使用导尿辅助工具的情况下进行。不幸的是，缺乏模拟模型以及无法预测何时需要 SPC，使得难以掌握这项技能。因此，初级医生经常坚持进行尿道导管插入术，从而增加了尿道损伤的风险。不当的导管插入术已被认为是尿道狭窄的原因。本研究旨在开发一种 SPC 模型，并评估其对受训者对此程序的信心的影响。
SPC 模型需要满足多项标准。它应该具有膀胱的解剖特征，并提供真实的视觉和触觉反馈。需要具有成本效益的模型副本，以便能够快速进行模拟，从而在有效的临床工作坊中使用。最后，受训者在使用该模型后应增加对执行该程序的理解和信心。该原型模型有 3 个解剖部分：膀胱、前腹壁和外壳腹部盒。最关键的部分是膀胱，它是一个带有 Mefix 胶带的气球，可防止在插入套管针时泄漏和“弹出”。
大多数临床学校都可以轻松复制这种 SPC 模型，并将其轻松添加到手术工作坊中，以确保受训者在需要对患者进行操作之前，先对此程序进行实际操作。
