Lee Jun Suh, Hong Tae Ho
Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
Ann Surg Treat Res. 2015 Jun;88(6):306-10. doi: 10.4174/astr.2015.88.6.306. Epub 2015 May 14.
The purpose of this study was to develop a porcine training model for laparoscopic choledochojejunostomy (CJ) that can act as a bridge between simulation models and actual surgery for novice surgeons. The feasibility of this model was evaluated.
Laparoscopic CJ using intracorporeal sutures was performed on ten animals by a surgical fellow with no experience in human laparoscopic CJ. A single layer of running sutures was placed in the posterior and anterior layers. Jejunojejunostomy was performed using a linear stapler, and the jejunal opening was closed using absorbable unidirectional sutures (V-Loc 180).
The average operation time was 131.3 ± 36.4 minutes, and the CJ time was 57.5 ± 18.4 minutes. Both the operation time and CJ time showed a steady decrease with an increasing number of cases. The average diameter of the CBD was 6.4 ± 0.8 mm. Of a total of ten animals, eight were sacrificed after the procedure. In two animals, a survival model was evaluated. Both pigs recovered completely and survived for two weeks, after which both animals were sacrificed. None of the animals exhibited any signs of bile leakage or anastomosis site stricture.
The porcine training model introduced in this paper is an adequate model for practicing laparoscopic CJ. Human tissue simulation is excellent.
本研究的目的是开发一种用于腹腔镜胆总管空肠吻合术（CJ）的猪训练模型，该模型可作为新手外科医生模拟模型与实际手术之间的桥梁。对该模型的可行性进行了评估。
由一名没有人类腹腔镜CJ经验的外科住院医师对十只动物进行使用体内缝合线的腹腔镜CJ。在后层和前层放置单层连续缝合线。使用线性吻合器进行空肠空肠吻合术，并用可吸收单向缝合线（V-Loc 180）关闭空肠开口。
平均手术时间为131.3±36.4分钟，CJ时间为57.5±18.4分钟。随着病例数的增加，手术时间和CJ时间均呈稳步下降趋势。胆总管的平均直径为6.4±0.8毫米。在总共十只动物中，八只在手术后被处死。对两只动物评估了存活模型。两只猪均完全康复并存活了两周，之后两只动物均被处死。所有动物均未表现出任何胆汁漏或吻合口狭窄的迹象。
本文介绍的猪训练模型是用于练习腹腔镜CJ的合适模型。对人体组织的模拟效果极佳。
