Cabello Ramiro, González Carmen, Quicios Cristina, Bueno Gonzalo, García Juan V, Arribas Ana B, Clascá Francisco
Urology Department, Fundación Jiménez Díaz-Idcsalud/Universidad Autónoma de Madrid, Madrid, Spain.
Urology Department, Fundación Jiménez Díaz-Idcsalud/Universidad Autónoma de Madrid, Madrid, Spain.
J Surg Educ. 2015 Mar-Apr;72(2):192-7. doi: 10.1016/j.jsurg.2014.10.002. Epub 2014 Dec 30.
To describe a novel cadaver-based model for practicing renal transplant (RT) surgery.
A simulating model using cadavers preserved by Thiel's method is developed to teach surgical anatomy and operative skills in RT surgery. Participants were asked to complete a voluntary, anonymous survey evaluating perceptions of the model and comparing cadaver sessions to other types of learning (rating questions from 0-10).
Large university teaching hospital.
A total of 28 residents, junior transplant surgeons, and faculty members were participants in the cadaver simulation.
Overall, 9 cadavers were used with 17 grafts transplanted. Kidney procurement in human cadavers preserved using Thiel's embalming technique was performed following the conventional protocol; en bloc nephrectomy with the trunk of aorta and inferior vena cava. Bench surgery was performed, perfusing artery with saline and checking vascular permeability. Once suitability is established, RT was performed as is done in clinical practice. This embalming method enables tissue dissection that is comparable to the living body and provides suitable conditions for realistic RT simulation; handling human tissues and vessels in the same surgical field as the clinical scenario. This experimental model approximates to in vivo RT, providing a realistic and interesting learning to inexperienced surgeons. Overall, participants held a positive view of the cadaver sessions, believed them to be useful in their daily practice, and felt that the proposed model was similar to the clinical setting. Trainees believed that these practices improved skills and confidence in performing an RT.
The proposed method of kidney procurement and RT in human cadavers preserved by Thiel's embalming technique is a promising, realistic, and reproducible method of practicing RT surgery.
描述一种用于练习肾移植（RT）手术的新型尸体模型。
开发一种使用经蒂尔方法保存的尸体的模拟模型，用于教授RT手术的手术解剖学和操作技能。要求参与者完成一项自愿、匿名的调查，评估对该模型的看法，并将尸体解剖课程与其他类型的学习进行比较（评分问题从0至10）。
大型大学教学医院。
共有28名住院医师、初级移植外科医生和教员参与了尸体模拟。
总体而言，使用了9具尸体，进行了17次移植。采用蒂尔防腐技术保存的人体尸体的肾脏获取按照常规方案进行；整块切除肾脏并连带主动脉和下腔静脉主干。进行了体外手术，用盐水灌注动脉并检查血管通透性。一旦确定合适性，就按照临床实践进行RT手术。这种防腐方法能够进行与活体相当的组织解剖，并为逼真的RT模拟提供合适条件；在与临床场景相同的手术视野中处理人体组织和血管。这个实验模型近似于体内RT，为缺乏经验的外科医生提供了现实且有趣的学习体验。总体而言，参与者对尸体解剖课程持积极看法，认为它们在日常实践中有用，并觉得所提出的模型与临床环境相似。学员们认为这些实践提高了进行RT手术的技能和信心。
所提出的采用蒂尔防腐技术保存人体尸体进行肾脏获取和RT手术的方法，是一种有前景且逼真、可重复的练习RT手术的方法。
