Barnes R W, Lang N P, Whiteside M F
Department of Surgery, University of Arkansas for Medical Sciences, Little Rock 72205.
Ann Surg. 1989 Jul;210(1):118-21. doi: 10.1097/00000658-198907000-00018.
This paper reviews the laboratory models used to teach fundamental surgical skills in our general surgery residency. The laboratory modules allow supervision and self-instruction, practice, and videotape monitoring of the following techniques: skin incision, suturing, knot tying, hemostasis, vascular anastomosis, and intestinal anastomosis. Pigs' feet simulate human skin for exercises in skin incision, lesion excision, suturing, and basic plastic surgical techniques. Latex tubing and penrose drains allow experience in suturing, knot tying, and hemostasis. Polytetrafluoroethylene vascular prostheses permit quantification of the precision of needle passage and suturing by measurement of leakage of water through a vascular anastomosis. Reconstituted, lyophilized, irradiated bovine arteries and ileum provide models of biologic tissue for creating handsewn vascular anastomoses and sutured or stapled gastrointestinal anastomoses. A headlamp videocamera allows unobstructive recording of the resident's technical performance and provides subsequent visual feedback for self-improvement when compared to reference instructional videotapes. We feel that these innovations may enhance surgical dexterity of residents without the need for animal sacrifice. Our goal is to foreshorten the learning curve for basic surgical skills and improve performance in the clinical operating room.
本文回顾了我们普通外科住院医师培训中用于教授基本外科技能的实验室模型。这些实验室模块允许对以下技术进行监督、自我指导、练习以及录像监测：皮肤切口、缝合、打结、止血、血管吻合和肠吻合。猪蹄模拟人类皮肤，用于皮肤切口、病变切除、缝合及基本整形外科技术的练习。乳胶管和凡士林引流管可用于缝合、打结和止血练习。聚四氟乙烯血管假体通过测量血管吻合处的水渗漏情况，可对进针和缝合的精确程度进行量化。冻干、辐照后的重组牛动脉和回肠为手工血管吻合以及缝合或吻合器吻合胃肠道提供了生物组织模型。头戴式摄像机可无障碍地记录住院医师的技术操作，并在与参考教学录像带对比时，为自我提高提供后续视觉反馈。我们认为这些创新措施可提高住院医师的手术操作灵活性，而无需牺牲动物。我们的目标是缩短基本外科技能的学习曲线，并提高在临床手术室中的操作表现。
