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使用蒂尔(Thiel)灌注固定人体尸体评估妇科恶性肿瘤的腹腔镜培训。

Assessment of laparoscopic training for gynecological malignancies using Thiel-embalmed human cadavers.

作者信息

Usami Tomoka, Fujioka Toru, Yoshida Ayaka, Miyaue Hitomi, Yasuoka Toshiaki, Uchikura Yuka, Takagi Kazuko, Matsubara Yuko, Matsumoto Takashi, Matsubara Keiichi, Sugiyama Takashi

机构信息

Department of Obstetrics and Gynecology, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan.

出版信息

Mol Clin Oncol. 2018 Nov;9(5):511-514. doi: 10.3892/mco.2018.1715. Epub 2018 Sep 7.

Abstract

The introduction of laparoscopic surgery has also been beneficial for patients with gynecological malignancies. In this respect, surgeons should receive related training in the context of human resource development. Hands-on training was introduced using Thiel-embalmed human cadavers (THCs) in 2014. To determine the usefulness of THCs, they were evaluated in terms of tissue color, consistency and operative tactility, among others, compared with laparoscopic training for gynecological malignancies. Hands-on training sessions using THCs were held for a total of 11 times at Ehime University Graduate School of Medicine between March 2014 and October 2017. Training on THCs included advanced laparoscopic procedures for radical hysterectomy type III. At the end of each training session, data were collected using a standardized, anonymous questionnaire termed the Likert scale. THCs ensured flexibility and plasticity of tissues and organs; therefore, the working space was similar to that in the living body under pneumoperitoneum. After analyzing the quality and consistency of tissue and organ color compared with conditions, most of the participants agreed or strongly agreed regarding the uterus, adnexa and ureter, but not regarding the large blood vessels. The highest scores were observed in the authenticity of the anatomical condition of each organ. Most participants strongly agreed that training using THCs would help improve their laparoscopic skills with a high level of satisfaction. Furthermore, most participants reported that they would recommend this training to other obstetrician-gynecologists. Laparoscopic training for gynecological malignancies using THCs was comparable to the conditions in terms of surgical view and operative tactility. Therefore, THCs may be an excellent training tool for improving laparoscopic surgical skills for gynecological malignancies.

摘要

腹腔镜手术的引入对妇科恶性肿瘤患者也有益处。在这方面,外科医生应在人力资源开发的背景下接受相关培训。2014年开始使用蒂尔(Thiel)防腐人体尸体(THC)进行实践培训。为了确定THC的实用性,将其在组织颜色、质地和手术触感等方面与妇科恶性肿瘤的腹腔镜培训进行了比较评估。2014年3月至2017年10月期间,在爱媛大学医学院共进行了11次使用THC的实践培训课程。对THC的培训包括III型根治性子宫切除术的高级腹腔镜手术。在每次培训课程结束时,使用一种标准化的匿名问卷(即李克特量表)收集数据。THC确保了组织和器官的柔韧性和可塑性;因此,工作空间与气腹状态下活体的工作空间相似。在分析了与实际情况相比组织和器官颜色的质量和一致性后,大多数参与者对子宫、附件和输尿管表示同意或强烈同意,但对大血管则不然。在每个器官解剖状况的真实性方面得分最高。大多数参与者强烈同意使用THC进行培训将有助于提高他们的腹腔镜技能,满意度很高。此外,大多数参与者报告说他们会向其他妇产科医生推荐这种培训。使用THC进行妇科恶性肿瘤的腹腔镜培训在手术视野和手术触感方面与实际情况相当。因此,THC可能是提高妇科恶性肿瘤腹腔镜手术技能的一种优秀培训工具。

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