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先天性心脏病外科模拟训练:不是选择,而是必需。

Congenital Heart Surgery Skill Training Using Simulation Models: Not an Option but a Necessity.

机构信息

Department of Diagnostic Imaging, Hospital for Sick Children, University of Toronto, Toronto, Canada.

Division of Cardiology, Department of Pediatrics, Labatt Family Heart Centre, Hospital for Sick Children, University of Toronto, Toronto, Canada.

出版信息

J Korean Med Sci. 2022 Oct 3;37(38):e293. doi: 10.3346/jkms.2022.37.e293.


DOI:10.3346/jkms.2022.37.e293
PMID:36193641
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9530313/
Abstract

Congenital heart surgery (CHS) is technically demanding, and its training is extremely complex and challenging. Training of the surgeon's technical skills has relied on a preceptorship format in which the trainees are gradually exposed to patients in the operating room under the close tutelage of senior staff surgeons. Training in the operating room is an inefficient process and the concept of a learning curve is no longer acceptable in terms of patient outcomes. The benefits of surgical simulation in training of congenital heart surgeons are well known and appreciated. However, adequate surgical simulation models and equipment for training have been scarce until the recent development of three-dimensionally (3D) printed models. Using comprehensive 3D printing and silicone-molding techniques, realistic simulation training models for most congenital heart surgical procedures have been produced. Newly developed silicone-molded models allow efficient CHS training in a stress-free environment with instantaneous feedback from the proctors and avoids risk to patients. The time has arrived when all congenital heart surgeons should consider surgical simulation training before progressing to real-life operating in a similar fashion to the aviation industry where all pilots are required to complete simulation training before flying a real aircraft. It is argued here that simulation training is not an option anymore but should be a mandatory component of CHS training.

摘要

先天性心脏病手术(CHS)技术要求高,其培训极其复杂和具有挑战性。外科医生技术技能的培训一直依赖于导师制模式,即受训者在资深外科医生的密切指导下,逐渐在手术室接触患者。手术室培训是一个效率低下的过程,从患者预后的角度来看,学习曲线的概念已经不再被接受。手术模拟在先天性心脏病外科医生培训中的益处是众所周知和赞赏的。然而,直到最近 3D 打印模型的发展,才有足够的用于培训的外科模拟模型和设备。使用全面的 3D 打印和硅模技术,已经生产出了大多数先天性心脏病手术程序的逼真模拟培训模型。新开发的硅模模型允许在无压力的环境中进行高效的 CHS 培训,并能即时从监考人员那里获得反馈,同时避免对患者的风险。现在是时候了,所有先天性心脏病外科医生在进行真实手术之前,都应该像航空业那样,考虑进行手术模拟培训,因为所有飞行员在驾驶真正的飞机之前都必须完成模拟培训。这里认为,模拟培训不再是一种选择,而应该成为 CHS 培训的强制性组成部分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd79/9530313/86af695ca418/jkms-37-e293-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd79/9530313/341ec6633c48/jkms-37-e293-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd79/9530313/6b06d9d42ed3/jkms-37-e293-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd79/9530313/b419e275a320/jkms-37-e293-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd79/9530313/f85aab75b88f/jkms-37-e293-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd79/9530313/464c77270011/jkms-37-e293-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd79/9530313/272919aa632e/jkms-37-e293-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd79/9530313/86af695ca418/jkms-37-e293-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd79/9530313/341ec6633c48/jkms-37-e293-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd79/9530313/6b06d9d42ed3/jkms-37-e293-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd79/9530313/b419e275a320/jkms-37-e293-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd79/9530313/f85aab75b88f/jkms-37-e293-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd79/9530313/464c77270011/jkms-37-e293-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd79/9530313/272919aa632e/jkms-37-e293-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fd79/9530313/86af695ca418/jkms-37-e293-g007.jpg

相似文献

[1]
Congenital Heart Surgery Skill Training Using Simulation Models: Not an Option but a Necessity.

J Korean Med Sci. 2022-10-3

[2]
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J Thorac Cardiovasc Surg. 2017-2-9

[3]
The Incorporation of Hands-On Surgical Training in a Congenital Heart Surgery Training Curriculum.

Ann Thorac Surg. 2021-11

[4]
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[5]
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[6]
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Pediatr Cardiol. 2018-3

[7]
Three-Dimensional Printing of Congenital Heart Disease Models for Cardiac Surgery Simulation: Evaluation of Surgical Skill Improvement among Inexperienced Cardiothoracic Surgeons.

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[8]
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World J Pediatr Congenit Heart Surg. 2024-5

[9]
Quantitative assessment of technical performance during hands-on surgical training of the arterial switch operation using 3-dimensional printed heart models.

J Thorac Cardiovasc Surg. 2019-12-20

[10]
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引用本文的文献

[1]
Evaluation of the Efficacy and Accuracy of Super-Flexible Three-Dimensional Heart Models of Congenital Heart Disease Made via Stereolithography Printing and Vacuum Casting: A Multicenter Clinical Trial.

J Cardiovasc Dev Dis. 2024-12-3

[2]
Analysis and Visualization of Inter-/Intra-surgeon Variability Using Surgical Simulation for Partial Anomalous Pulmonary Venous Connection Repair.

Pediatr Cardiol. 2024-11-1

[3]
Longitudinal Evaluation of Congenital Cardiovascular Surgical Performance and Skills Retention Using Silicone-Molded Heart Models.

World J Pediatr Congenit Heart Surg. 2024-5

[4]
Patient-Specific 3D-Printed Models in Pediatric Congenital Heart Disease.

Children (Basel). 2023-2-7

本文引用的文献

[1]
The use of objective assessments in the evaluation of technical skills in cardiothoracic surgery: a systematic review.

Interact Cardiovasc Thorac Surg. 2022-8-3

[2]
State-of-the-art silicone molded models for simulation of arterial switch operation: Innovation with parting-and-assembly strategy.

JTCVS Tech. 2022-1-19

[3]
Is it time to incorporate hands-on simulation into the cardiothoracic surgery curriculum?

Interact Cardiovasc Thorac Surg. 2022-3-31

[4]
Extended, virtual and augmented reality in thoracic surgery: a systematic review.

Interact Cardiovasc Thorac Surg. 2022-1-18

[5]
Commentary: A new "lost" generation.

JTCVS Open. 2021-9

[6]
Do-it-yourself simulators and building a culture of practice in the virtual era.

JTCVS Tech. 2021-5-19

[7]
Comparison of cardiothoracic surgical training before and during the COVID-19 pandemic in the United Kingdom.

JTCVS Open. 2021-9

[8]
Current Status of Training and Certification for Congenital Heart Surgery Around the World: Proceedings of the Meetings of the Global Council on Education for Congenital Heart Surgery of the World Society for Pediatric and Congenital Heart Surgery.

World J Pediatr Congenit Heart Surg. 2021-5

[9]
3D Modeling and Printing in Congenital Heart Surgery: Entering the Stage of Maturation.

Front Pediatr. 2021-2-5

[10]
Three-Dimensional Printing of Congenital Heart Disease Models for Cardiac Surgery Simulation: Evaluation of Surgical Skill Improvement among Inexperienced Cardiothoracic Surgeons.

Korean J Radiol. 2021-5

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