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腹腔镜肾盂成形术中输尿管肾盂吻合的模拟训练模型

Simulated training model of ureteropyelic anastomosis in laparoscopic pyeloplasty.

作者信息

Lima Juliana Cynara Santos, Rocha Hermano Alexandre Lima, Mesquita Francisco José Cabral, Araújo David Augusto Batista Sá, Silveira Rômulo Augusto da, Borges Gleydson Cesar

机构信息

MD, MSc, Centro Universitário Christus, Fortaleza - CE, Brazil. Conception, acquisition and analysis of data, manuscript writing, critical revision, final approval.

PhD, Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, USA, and Department of Community Health, Universidade Federal do Ceará, Fortaleza - CE, Brazil. Conception, acquisition and analysis of data, statistics analysis, manuscript writing, critical revision, final approval.

出版信息

Acta Cir Bras. 2020 Dec 18;35(11):e351108. doi: 10.1590/ACB351108. eCollection 2020.

DOI:10.1590/ACB351108
PMID:33331458
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7748080/
Abstract

PURPOSE

To develop a model for simulated training of ureteropyelic anastomosis in laparoscopicpyeloplasty.

METHODS

Longitudinal and experimental study, with 16 participants. A synthetic instrument was produced to simulate the renal pelvis and the proximal portion of the ureter positioned on a platform within laparoscopic simulators, thereby resulting in the realistic simulation of the ureteropelvic anastomosis. A step-by-step guide was also developed for the accomplishment of the ureteropelvic anastomosis training model.

RESULTS

In the evaluation of all participants' suture training, a decrease was found in the time needed to perform the anastomosis, with a median of 17.83 min in the 1st step and 14.21 min in the last one (p = 0.01). Regarding the knots, in the 1st step, 5% of them were considered firm, with an evolution to 30% in the last step (p = 0.011).

CONCLUSION

We noticed improvement in the ability to perform the ureteropelvic anastomosis by participants with no experience with it. Therefore, even unexperienced participants can improve their skills with this training. Moreover, we observed the effectiveness of the model use, confirmed by the participants' opinion and its validation by expert surgeons.

摘要

目的

建立一种用于腹腔镜肾盂成形术中输尿管肾盂吻合术模拟训练的模型。

方法

纵向实验研究，有16名参与者。制作了一种合成器械，用于模拟肾盂和位于腹腔镜模拟器平台上的输尿管近端部分，从而实现输尿管肾盂吻合术的逼真模拟。还制定了一份完成输尿管肾盂吻合术训练模型的分步指南。

结果

在对所有参与者缝合训练的评估中，发现进行吻合所需的时间有所减少，第一步的中位数为17.83分钟，最后一步为14.21分钟（p = 0.01）。关于打结，第一步时，5%的结被认为牢固，最后一步时这一比例提高到30%（p = 0.011）。

结论

我们注意到没有输尿管肾盂吻合术经验的参与者在进行该手术的能力上有提高。因此，即使是没有经验的参与者也可以通过这种训练提高技能。此外，我们观察到了该模型使用的有效性，这得到了参与者意见的证实以及专家外科医生的验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5273/7748080/c6c2f4609198/1678-2674-acb-35-11-e351108-gf04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5273/7748080/8b4c0b183904/1678-2674-acb-35-11-e351108-gf01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5273/7748080/0b757049de4e/1678-2674-acb-35-11-e351108-gf02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5273/7748080/b6b64aa23913/1678-2674-acb-35-11-e351108-gf03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5273/7748080/c6c2f4609198/1678-2674-acb-35-11-e351108-gf04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5273/7748080/8b4c0b183904/1678-2674-acb-35-11-e351108-gf01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5273/7748080/0b757049de4e/1678-2674-acb-35-11-e351108-gf02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5273/7748080/b6b64aa23913/1678-2674-acb-35-11-e351108-gf03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5273/7748080/c6c2f4609198/1678-2674-acb-35-11-e351108-gf04.jpg

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