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腹腔镜阑尾切除术环扎模拟器的开发与评估。

Development and assessment of a loop ligation simulator for laparoscopic appendectomy.

机构信息

Department of Pediatric Surgery, Children's Hospital Lucerne, 6000, Lucerne 16, Switzerland.

University of Lucerne, Lucerne, Switzerland.

出版信息

Pediatr Surg Int. 2024 Mar 21;40(1):86. doi: 10.1007/s00383-024-05664-6.

DOI:10.1007/s00383-024-05664-6
PMID:38512596
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10957642/
Abstract

OBJECTIVE

Loop ligation of the appendix is a challenging surgical skill and well suited to be trained in a simulator. We aimed to develop an affordable and easy-to-build simulator and test its training effect.

DESIGN AND PARTICIPANTS

Different materials were tested, and the best training modality was identified by researching the literature. The developed simulator training was tested on 20 surgical novices.

RESULTS

A video was produced including an instruction on how to build the simulator and a step-by-step tuition on how to ligate the appendix. The Peyton approach was utilized to guide learners. Training with the simulator leads to reliable skill acquisition. All participants improved significantly in completing the task successfully during the structured learning.

CONCLUSION

We succeeded in developing a simulator for loop ligation of the appendix during laparoscopic appendectomy. Participants significantly improve in handling the loops. The transferability of the skill learned during simulation to the operating room will be subject of a follow-up study.

摘要

目的

阑尾环扎术是一项具有挑战性的外科技能,非常适合在模拟器中进行训练。我们旨在开发一种经济实惠且易于构建的模拟器,并测试其培训效果。

设计和参与者

研究文献确定了不同的材料,并确定了最佳的培训模式。开发的模拟器培训在 20 名外科新手身上进行了测试。

结果

制作了一段视频,其中包括如何构建模拟器的说明以及如何结扎阑尾的分步教程。利用佩顿方法来指导学习者。使用模拟器进行训练可实现可靠的技能获取。所有参与者在结构化学习期间成功完成任务的能力都显著提高。

结论

我们成功地开发了一种腹腔镜阑尾切除术时用于阑尾环扎术的模拟器。参与者在处理环方面有了显著的提高。在手术室中学习到的技能的可转移性将是后续研究的主题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5760/10957642/401e77bd929f/383_2024_5664_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5760/10957642/1ed4a8bbf8ef/383_2024_5664_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5760/10957642/cead01e41236/383_2024_5664_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5760/10957642/401e77bd929f/383_2024_5664_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5760/10957642/1ed4a8bbf8ef/383_2024_5664_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5760/10957642/cead01e41236/383_2024_5664_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5760/10957642/401e77bd929f/383_2024_5664_Fig3_HTML.jpg

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本文引用的文献

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In Pursuit of the Most Cost-Effective Laparoscopic Appendicectomy: A Review of the Literature.追求最具成本效益的腹腔镜阑尾切除术:文献回顾。
Surg Innov. 2023 Oct;30(5):601-606. doi: 10.1177/15533506231169072. Epub 2023 Apr 20.
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Cost-Effective Approach to the Laparoscopic Appendectomy : Balancing Disposable Instrument Cost With Operative Time.腹腔镜阑尾切除术的成本效益方法:平衡一次性器械成本与手术时间。
Am Surg. 2020 Jun;86(6):715-720. doi: 10.1177/0003134820923337.
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Cognitivism and psychomotor skills in surgical training: from theory to practice.
外科培训中的认知主义与心理运动技能:从理论到实践
Int J Med Educ. 2018 Sep 28;9:253-254. doi: 10.5116/ijme.5b9a.129b.
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A Suggestion on How to Compare 2D and 3D Laparoscopy: A Qualitative Analysis of the Literature and Randomized Pilot Study.关于如何比较二维和三维腹腔镜检查的建议:文献定性分析与随机试点研究
J Laparoendosc Adv Surg Tech A. 2019 Jan;29(1):114-120. doi: 10.1089/lap.2018.0164. Epub 2018 Sep 25.
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Use of Entrustable Professional Activities in the Assessment of Surgical Resident Competency.使用可委托的专业活动评估外科住院医师的能力。
JAMA Surg. 2018 Apr 1;153(4):335-343. doi: 10.1001/jamasurg.2017.4547.
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In Pursuit of the Most Cost-Effective Pediatric Laparoscopic Appendectomy: The Effect of Disposable Instrument Choice on Operative Time and Surgeon-Controllable Cost.追求最具成本效益的小儿腹腔镜阑尾切除术:一次性器械选择对手术时间和外科医生可控成本的影响
J Laparoendosc Adv Surg Tech A. 2017 Dec;27(12):1309-1313. doi: 10.1089/lap.2017.0288. Epub 2017 Oct 25.
7
Halsted's "See One, Do One, and Teach One" versus Peyton's Four-Step Approach: A Randomized Trial for Training of Laparoscopic Suturing and Knot Tying.霍尔斯特德的“看一个,做一个,教一个”与佩顿的四步法:腹腔镜缝合与打结训练的随机试验
J Surg Educ. 2018 Mar-Apr;75(2):510-515. doi: 10.1016/j.jsurg.2017.07.025. Epub 2017 Aug 8.
8
Intended cost reduction in laparoscopic appendectomy by introducing the endoloop: a single center experience.通过引入Endoloop环实现腹腔镜阑尾切除术预期的成本降低:单中心经验
BMC Surg. 2017 Jul 11;17(1):80. doi: 10.1186/s12893-017-0277-z.
9
Innovations in surgery simulation: a review of past, current and future techniques.手术模拟的创新:对过去、当前和未来技术的综述
Ann Transl Med. 2016 Dec;4(23):453. doi: 10.21037/atm.2016.12.24.
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Complications in common general pediatric surgery procedures.普通儿科常见外科手术中的并发症。
Semin Pediatr Surg. 2016 Dec;25(6):404-411. doi: 10.1053/j.sempedsurg.2016.10.002. Epub 2016 Oct 29.