Hanssen Andres, Hanssen Diego A, Hanssen Rafael A, Plotnikov Sergio, Haddad Jose, Daes Jorge E
Surgery Department Clínica Iberoamérica, Universidad Metropolitana de Barranquilla, Barranquilla, Colombia.
Department of Surgery, Bronx Care Health System, Albert Einstein ICAHAN School of Medicine, New York, NY, United States.
J Abdom Wall Surg. 2022 Mar 23;1:10305. doi: 10.3389/jaws.2022.10305. eCollection 2022.
The aim of this study was to develop and validate a reproducible low-cost model useful for the development and acquisition of skills and competencies required for endoscopic hernia repairs. Ten general surgery residents (PGY3) were instructed to construct the model and perform the maneuvers necessary for the simulation of laparoscopic inguinal hernioplasty by the -abdominal pre-peritoneal (TAPP) technique. They practiced for 4 weeks in the model, and the time required to perform simulated hernioplasty by the laparoscopic TAPP technique in the initial session was compared to the time required after 4 weeks of training. The time required to perform the exercise was significantly lower than in the initial session ( < 0.01). The time required by residents to complete the exercise in the initial session was significantly longer than that used by expert surgeons in the same task ( < 0.01), and although a significant difference persisted, this difference was substantially reduced to 3.60 min after the residents completed 4-week training in the model ( < 0.01). An independent expert, blinded to the level of training of the person who performed the exercise, could recognize all residents as novices and all experienced surgeons as experts in the initial session of the exercise with the model, but after 4 weeks of training, they did not recognize 4 of the 10 residents as novices ( < 0.05). The routine implementation of training in this model could be very useful in the laparoscopic inguinal hernioplasty teaching-learning process.
本研究的目的是开发并验证一种可重复的低成本模型，该模型有助于培养和获得内镜下疝修补所需的技能和能力。10名普通外科住院医师（PGY3）被指导构建该模型，并通过经腹腹膜前（TAPP）技术进行模拟腹腔镜腹股沟疝修补术所需的操作。他们在该模型中练习了4周，并将初次练习时通过腹腔镜TAPP技术进行模拟疝修补术所需的时间与训练4周后的时间进行比较。练习所需时间明显低于初次练习时（<0.01）。住院医师在初次练习时完成练习所需的时间明显长于专家外科医生完成相同任务所需的时间（<0.01），尽管差异仍然显著，但在住院医师在该模型中完成4周训练后，这一差异大幅缩小至3.60分钟（<0.01）。一名对进行练习者的训练水平不知情的独立专家，在使用该模型进行练习的初次阶段，能够将所有住院医师识别为新手，将所有经验丰富的外科医生识别为专家，但在4周训练后，他们没有将10名住院医师中的4名识别为新手（<0.05）。在该模型中进行常规训练对腹腔镜腹股沟疝修补术的教学过程可能非常有用。
