.MD. Santa Casa de Misericórdia de Fortaleza - Department of General Surgery - Fortaleza (Ceará), Brazil.
MD. Santa Casa de Misericórdia de Fortaleza - Department of General Surgery - Fortaleza (Ceará), Brazil.
Acta Cir Bras. 2021 Feb 15;36(1):e360108. doi: 10.1590/ACB360108. eCollection 2021.
Develop a 3D model for the simulation of laparoscopic inguinal hernioplasty transabdominal preperitoneal (TAPP).
This is an experimental study, 18 participants were selected, divided into three groups, experimental (GE) surgeons in training, control (GC) experienced surgeons and Shaw (GS) nonexperienced surgeons. The simulation in the 3D model was carried out in 6 sessions fulfilling the 5 stages. Opening the peritoneum with the creation of the preperitoneal space; identification of important structures; hernia identification and reduction; placement and fixation of the mesh in Cooper's ligament and closure of the peritoneum.
In the 1st stage, the GE obtained an average of 1.25 ± 0.42 in the 1st session and 3.25 ± 0.62 in the 6th session (p = 0.05) and in the 5th stage 0.91 ± 0.29 in the first session. 1st session and 1.91 ± 0.29 in the 6th session (p = 0.001), with no significant difference between groups. The learning and skill curve in the SG represented 1.08 ± 0.29 1st and 3.50 ± 0.90 6th session (p = 0.001).
The creation of a systematization of training in simulation applied to the three-dimensional model enabled gain in laparoscopic skills and underpinned its theoretical and practical foundations.
开发一种用于模拟腹腔镜腹股沟疝经腹腹膜前（TAPP）修补术的 3D 模型。
这是一项实验研究，选择了 18 名参与者，分为三组，培训中的实验（GE）外科医生、经验丰富的对照组（GC）外科医生和非经验丰富的 Shaw（GS）外科医生。在 3D 模型中进行了 6 次模拟，完成了 5 个阶段。打开腹膜，创建腹膜前间隙；识别重要结构；识别和缩小疝；将网片放置和固定在库珀韧带中，并关闭腹膜。
在第 1 阶段，GE 在第 1 次会议中平均获得 1.25±0.42，在第 6 次会议中获得 3.25±0.62（p=0.05），在第 5 阶段，在第 1 次会议中获得 0.91±0.29，在第 6 次会议中获得 1.91±0.29（p=0.001），组间无显著差异。SG 的学习和技能曲线表示第 1 次会议中 1.08±0.29 和第 6 次会议中 3.50±0.90（p=0.001）。
在模拟中创建培训的系统化应用于三维模型，使腹腔镜技能得到提高，并为其提供了理论和实践基础。
