Mansoor A, Curinier S, Campagne-Loiseau S, Platteeuw L, Jacquetin B, Rabischong B
Centre Hospitalier Issoire, 13 rue Dr Sauvat, 63500, Issoire, France.
University Hospital Estaing, Pelviperineology Unit, Clermont-Ferrand, France.
Int Urogynecol J. 2017 Oct;28(10):1595-1597. doi: 10.1007/s00192-017-3292-9. Epub 2017 Mar 14.
This aim of this study was to evaluate the feasibility and usefulness of an ovine model for training in vaginal surgery.
Four senior urogynaecological surgeons and five residents attended five sessions of vaginal surgery for pelvic organ prolapse (POP) in five old multiparous female sheep. Urogynaecological examinations were performed and measurements similar to the POP-Q classification in humans were obtained. Standard POP surgical procedures with and without mesh were performed. A pelvic CT scan was done on one animal and the structures were compared with the pelvic structures in a woman. After the feasibility of vaginal surgery had been established in three cadavers, surgery was performed in two living animals under general anaesthesia and was followed by laparoscopy to explore the internal pelvic anatomy.
We found anatomic similarities in the vaginal and pelvic structures between sheep and women. After caudal traction on the cervix, all five sheep had significant POP of stage 3 or 4. We proved the feasibility of all types of vaginal surgery in this animal model: traditional anterior and posterior repair, apex fixation and anterior wall repair with mesh. The video shows the internal pelvic anatomy and different vaginal procedures.
This study showed that training in vaginal surgery for POP is feasible and useful in an animal model, the ewe, that has vaginal and pelvic structures very similar to those in women.
本研究的目的是评估绵羊模型用于阴道手术训练的可行性和实用性。
四位资深泌尿妇科外科医生和五位住院医生在五只老龄经产雌性绵羊身上进行了五期盆腔器官脱垂（POP）阴道手术。进行了泌尿妇科检查，并获得了与人类POP-Q分类相似的测量结果。实施了有无网片的标准POP外科手术。对一只动物进行了盆腔CT扫描，并将其结构与女性盆腔结构进行了比较。在三只尸体上确定了阴道手术的可行性后，在两只活体动物身上进行了全身麻醉下的手术，随后进行腹腔镜检查以探索盆腔内部解剖结构。
我们发现绵羊和女性的阴道及盆腔结构存在解剖学相似性。在对子宫颈进行尾侧牵引后，所有五只绵羊均出现了3期或4期的显著POP。我们证明了在该动物模型中所有类型阴道手术的可行性：传统的前后壁修补术、顶端固定术以及网片修补前壁手术。视频展示了盆腔内部解剖结构和不同的阴道手术过程。
本研究表明，在具有与女性非常相似的阴道和盆腔结构的母羊动物模型中，进行盆腔器官脱垂阴道手术训练是可行且有用的。
