Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Glückstrasse 11, 91054, Erlangen, Germany.
BMC Med Educ. 2023 Oct 12;23(1):765. doi: 10.1186/s12909-023-04667-6.
Unilateral cleft lip surgery is a complex procedure, and the outcome depends highly on the surgeon's experience. Digital simulations and low-fidelity models seem inadequate for effective surgical education and training. There are only few realistic models for haptic simulation of cleft surgery, which are all based on synthetic materials that are costly and complex to produce. Hence, they are not fully available to train and educate surgical trainees. This study aims to develop an inexpensive, widely available, high-fidelity, ex vivo model of a unilateral cleft lip using a porcine snout disc.
A foil template was manufactured combining anatomical landmarks of the porcine snout disc and the anatomical situation of a child with a unilateral cleft. This template was used to create an ex vivo model of a unilateral cleft lip from the snout disc. Millard II technique was applied on the model to proof its suitability. The individual steps of the surgical cleft closure were photo-documented and three-dimensional scans of the model were analysed digitally. Sixteen surgical trainees were instructed to create a unilateral cleft model and perform a unilateral lip plasty. Their self-assessment was evaluated by means of a questionnaire.
The porcine snout disc proved highly suitable to serve as a simulation model for unilateral cleft lip surgery. Millard II technique was successfully performed as we were able to perform all steps of unilateral cleft surgery, including muscle suturing. The developed foil-template is reusable on any porcine snout disc. The creation of the ex vivo model is simple and inexpensive. Self-assessment of the participants showed a strong increase in comprehension and an eagerness to use the model for surgical training.
A porcine snout disc ex vivo model of unilateral cleft lips was developed successfully. It shows many advantages, including a haptic close to human tissue, multiple layers, low cost, and wide and rapid availability. It is therefore very suitable for teaching and training beginners in cleft surgery and subsequently improving surgical skills and knowledge. Further research is needed to finally assess the ex vivo model's value in different stages of the curriculum of surgical residency.
单侧唇裂手术是一个复杂的过程，其结果高度依赖于外科医生的经验。数字模拟和低保真模型似乎不足以进行有效的手术教育和培训。虽然有一些用于裂手术触觉模拟的真实模型，但它们都是基于昂贵且复杂的合成材料制成的，因此无法完全用于培训和教育外科受训者。本研究旨在使用猪鼻碟开发一种经济实惠、广泛可用、高保真、离体的单侧唇裂模型。
制造了一个箔模板，该模板结合了猪鼻碟的解剖学标志和单侧裂儿童的解剖情况。使用该模板从鼻碟创建单侧唇裂的离体模型。在模型上应用 Millard II 技术以证明其适用性。手术裂隙闭合的各个步骤都进行了拍照记录，并对模型进行了数字三维扫描分析。指导 16 名外科受训者创建单侧裂模型并进行单侧唇成形术。通过问卷调查评估他们的自我评估。
猪鼻碟非常适合用作单侧唇裂手术的模拟模型。我们能够成功进行 Millard II 技术，完成单侧唇裂手术的所有步骤，包括肌肉缝合。开发的箔模板可在任何猪鼻碟上重复使用。离体模型的创建简单且经济实惠。参与者的自我评估显示，他们对理解的认识有了很大提高，并渴望将该模型用于手术培训。
成功开发了一种猪鼻碟离体单侧唇裂模型。它具有许多优点，包括接近人体组织的触觉、多层结构、低成本以及广泛而快速的可用性。因此，它非常适合教授和培训裂手术初学者，并随后提高手术技能和知识。需要进一步的研究来最终评估离体模型在外科住院医师课程不同阶段的价值。
