Department of Surgery, Tokyo Medical University, Tokyo, Japan.
Interact Cardiovasc Thorac Surg. 2021 Jan 22;32(2):284-290. doi: 10.1093/icvts/ivaa240.
We performed a comparative analysis of the performance of video-assisted thoracic surgery (VATS) lobectomy simulation using three-dimensional-printed Biotexture lung models by surgeons classified according to their level of expertise. The aim of this study was to investigate the association between surgeons' experience and time to complete the VATS lobectomy simulation.
Participants were divided into 3 groups: group A included those who had no experience of actual VATS lobectomy (n = 11), group B included those who had performed 5-10 VATS lobectomies (n = 12) and group C included those who had performed >100 VATS lobectomies (n = 6). Their performances were assessed based on total procedure time, duration to the exposure of the vessels, ligation of the arteries and stapling of the fissures. After the simulation, a questionnaire survey was performed.
The median total procedure time was significantly shorter in the group of surgeons with more experience (A vs B, P < 0.001; B vs C, P = 0.034; A vs C, P < 0.001). Regarding 'the exposure of all the vessels to be resected' and 'ligation of the arteries', group B completed these steps in less time than group A (P = 0.024 and P = 0.012, respectively). In the questionnaire, all groups answered that this simulation was useful for novices to improve their skills.
Although time to complete the VATS lobectomy simulation is only a part of evaluation points for real skills, this model can facilitate basic skill acquisitions for novices.
我们对三种不同水平的外科医生使用三维打印生物纹理肺模型进行胸腔镜肺叶切除术模拟的表现进行了比较分析。本研究旨在探讨外科医生经验与完成胸腔镜肺叶切除术模拟所需时间之间的关系。
将参与者分为三组:A 组为从未进行过实际胸腔镜肺叶切除术的外科医生(n=11),B 组为进行过 5-10 例胸腔镜肺叶切除术的外科医生(n=12),C 组为进行过>100 例胸腔镜肺叶切除术的外科医生(n=6)。根据总手术时间、暴露血管的时间、动脉结扎时间和裂隙缝合时间来评估他们的表现。模拟结束后进行问卷调查。
经验丰富的外科医生组的总手术时间明显更短(A 组与 B 组,P<0.001;B 组与 C 组,P=0.034;A 组与 C 组,P<0.001)。在“暴露所有要切除的血管”和“动脉结扎”方面,B 组比 A 组完成这些步骤的时间更短(P=0.024 和 P=0.012)。在问卷调查中,所有组都回答说这种模拟对于新手提高技能很有用。
虽然完成胸腔镜肺叶切除术模拟所需的时间仅是对实际技能的评估点之一,但这种模型可以帮助新手掌握基本技能。