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[关于单孔电视辅助胸腔镜手术培训的思考]

[Thinking on the Training of Uniportal Video-assisted Thoracic Surgery].

作者信息

Zhu Yuming, Jiang Gening

机构信息

Department of General Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China.

出版信息

Zhongguo Fei Ai Za Zhi. 2018 Apr 20;21(4):260-264. doi: 10.3779/j.issn.1009-3419.2018.04.04.

DOI:10.3779/j.issn.1009-3419.2018.04.04
PMID:29587901
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5973337/
Abstract

Recently, uniportal video-assisted thoracic surgery (VATS) has developed rapidly and has become the main theme of global surgical development. The specific, standardized and systematic training of this technology has become an important topic. Specific training in the uniportal VATS approach is crucial to ensure safety and radical treatment. Such training approach, including a direct interaction with experienced surgeons in high-volume centers, is crucial and represents an indispensable step. Another form of training that usually occurs after preceptorship is proctorship: an experienced mentor can be invited to a trainee's own center to provide specific on-site tutelage. Videos published online are commonly used as training material. Technology has allowed the use of different models of simulators for training. The most common model is the use of animal wet laboratory training. Other models, however, have been used mostrecently, such as the use of 3D and VR Technology, virtual reality simulators, and completely artificial models of the human thorax with synthetic lung, vessel, airway, and nodal tissues. A short-duration, high-volume, clinical immersion training, and a long term systematic training in high-volume centers are getting more and more attention. According to the evaluation of students' grading, a diversified training mode is adopted and the targeted training in accordance with different students helps to improve the training effect. We have done some work in systematic and standardized training of uniportal VATS in single center. We believe such training is feasible and absolutely necessary.

摘要

近年来,单孔电视辅助胸腔镜手术(VATS)发展迅速,已成为全球外科发展的主题。这项技术的具体、标准化和系统化培训已成为一个重要课题。单孔VATS手术的专项培训对于确保手术安全和根治性治疗至关重要。这种培训方式,包括在高容量中心与经验丰富的外科医生直接互动,至关重要且是不可或缺的一步。另一种通常在导师指导之后进行的培训形式是监考:可以邀请一位经验丰富的导师到学员自己的中心提供具体的现场指导。在线发布的视频通常用作培训材料。技术使得可以使用不同的模拟器模型进行培训。最常见的模型是使用动物实体实验室培训。然而,最近也使用了其他模型,例如使用3D和VR技术、虚拟现实模拟器,以及带有合成肺、血管、气道和淋巴结组织的完全人造的人体胸部模型。短期、高容量的临床沉浸式培训以及在高容量中心进行的长期系统培训越来越受到关注。根据学生的评分评估,采用多样化的培训模式,针对不同学生进行有针对性的培训有助于提高培训效果。我们在单中心单孔VATS的系统和标准化培训方面做了一些工作。我们认为这种培训是可行且绝对必要的。

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本文引用的文献

1
VATS lobectomy program: the trainee perspective.电视辅助胸腔镜肺叶切除术项目:实习生视角
J Thorac Dis. 2016 Apr;8(Suppl 4):S427-30. doi: 10.21037/jtd.2016.03.82.
2
Uniportal video-assisted thoracic (VATS) lobectomy.单孔电视辅助胸腔镜肺叶切除术
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Uniportal video-assisted thoracic surgery.单孔电视辅助胸腔镜手术
Ann Cardiothorac Surg. 2016 Mar;5(2):75. doi: 10.21037/acs.2016.03.04.
4
The Society of Thoracic Surgeons Expert Consensus Statement: A Tool Kit to Assist Thoracic Surgeons Seeking Privileging to Use New Technology and Perform Advanced Procedures in General Thoracic Surgery.胸外科医师协会专家共识声明:协助胸外科医师申请使用新技术及开展普通胸外科高级手术权限的工具包。
Ann Thorac Surg. 2016 Mar;101(3):1230-7. doi: 10.1016/j.athoracsur.2016.01.061.
5
Reasons not to perform uniportal VATS lobectomy.不进行单孔电视辅助胸腔镜肺叶切除术的原因。
J Thorac Dis. 2016 Mar;8(Suppl 3):S333-43. doi: 10.3978/j.issn.2072-1439.2016.02.41.
6
Non-intubated video-assisted thoracoscopic lung resections: the future of thoracic surgery?非插管电视辅助胸腔镜肺切除术:胸外科手术的未来?
Eur J Cardiothorac Surg. 2016 Mar;49(3):721-31. doi: 10.1093/ejcts/ezv136. Epub 2015 Apr 19.
7
Is the learning curve for video-assisted thoracoscopic lobectomy affected by prior experience in open lobectomy?电视辅助胸腔镜肺叶切除术的学习曲线是否会受到开放性肺叶切除术既往经验的影响?
Interact Cardiovasc Thorac Surg. 2015 Jul;21(1):108-12. doi: 10.1093/icvts/ivv090. Epub 2015 Apr 15.
8
Modern impact of video assisted thoracic surgery.电视辅助胸腔镜手术的现代影响。
J Thorac Dis. 2014 Oct;6(Suppl 6):S631-6. doi: 10.3978/j.issn.2072-1439.2014.08.02.
9
The evolution of minimally invasive thoracic surgery: implications for the practice of uniportal thoracoscopic surgery.微创胸外科的发展:对单孔胸腔镜手术实践的影响。
J Thorac Dis. 2014 Oct;6(Suppl 6):S604-17. doi: 10.3978/j.issn.2072-1439.2014.08.52.
10
Is uniportal thoracoscopic surgery a feasible approach for advanced stages of non-small cell lung cancer?单孔胸腔镜手术对于非小细胞肺癌晚期患者是否可行?
J Thorac Dis. 2014 Jun;6(6):641-8. doi: 10.3978/j.issn.2072-1439.2014.05.17.