Department of Surgery, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan.
Surg Endosc. 2020 May;34(5):1923-1928. doi: 10.1007/s00464-019-06964-y. Epub 2019 Jul 16.
The pre-operative three-dimensional (3D) imaging technique has resulted in a better surgical outcome for patients and has been used as an education and diagnostic tool. However, there are no reports concerning the usefulness of the 3D imaging technique in laparoscopic transabdominal pre-peritoneal repair (TAPP) so the aim of this study was to investigate the usefulness of the 3D imaging technique in laparoscopic TAPP as an educational tool for medical students.
Six (6) patients who underwent laparoscopic TAPP for inguinal hernia were enrolled in this study. 3D reconstruction was performed from pre-operative computed tomography (CT) and the usefulness of pre-operative 3D simulation compared with intra-operative laparoscopic imaging was validated. Moreover, thirty (30) medical students at the university completed a multiple-choice questionnaire (MCQ) to determine the level of their satisfaction and understanding of anatomy resulting from the study.
The local anatomy of the patients was identified as the same during the operation as the pre-operative 3D simulation. The results of the MCQ showed that most of the medical students were extremely (23%) or very (67%) satisfied with the effect of pre-operative 3D simulation on the quality of the surgery. Moreover, most students could understand the surgery anatomy by the 3D simulation extremely well (40%) or very well (47%) and agreed on the usefulness of this procedure for learning anatomy.
Pre-operative 3D simulation increases the understanding of detailed anatomy and virtual three-dimensional image analysis in laparoscopic TAPP is useful as an educational tool for medical students.
术前三维（3D）成像技术已为患者带来更好的手术效果，并被用作教育和诊断工具。然而，目前尚无关于 3D 成像技术在腹腔镜经腹腹膜前修补术（TAPP）中应用的报道，因此本研究旨在探讨 3D 成像技术在腹腔镜 TAPP 中作为医学生教学工具的实用性。
本研究纳入了 6 例接受腹腔镜 TAPP 治疗腹股沟疝的患者。从术前计算机断层扫描（CT）中进行 3D 重建，并验证了术前 3D 模拟与术中腹腔镜成像的实用性。此外，30 名大学医学生完成了多项选择题（MCQ），以确定他们对研究结果导致的解剖学理解和满意度的水平。
手术过程中患者的局部解剖与术前 3D 模拟相同。MCQ 的结果表明，大多数医学生对术前 3D 模拟对手术质量的影响非常满意（23%）或满意（67%）。此外，大多数学生可以通过 3D 模拟非常好（40%）或很好（47%）地理解手术解剖学，并认同该程序对学习解剖学的有用性。
术前 3D 模拟增加了对腹腔镜 TAPP 中详细解剖结构的理解，虚拟三维图像分析可作为医学生的教学工具。
