Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy.
Institute of Anesthesia and Intensive Care, Padua University Hospital, Padua, Italy.
Surg Endosc. 2024 Oct;38(10):5815-5823. doi: 10.1007/s00464-024-11119-9. Epub 2024 Aug 19.
Nowadays, video-assisted thoracic surgery (VATS) lobectomy represents the treatment of choice for early-stage lung cancer. Over the years, different methods for VATS training have evolved. The aim of this study is to present an innovative beating-heart filled-vessel cadaveric model to simulate VATS lobectomies.
Via selective cannulation of the cadaver heart, the pulmonary vessels were filled with a gel to improve their haptic feedback. An endotracheal tube with a balloon on its tip then allowed movement of the heart chambers, transmitting a minimum of flow to the pulmonary vessels. A simulated OR was created, using all instrumentation normally available during surgery on living patients, with trainees constantly mentored by experienced surgeons. At the end of each simulation, the participants were asked 5 questions on a scale of 1 to 10 to evaluate the effectiveness of the training method ("1" being ineffective and "10" being highly effective).
Eight models were set up, each with a median time of 108 min and a cost of €1500. Overall, 50 surgeons were involved, of which 39 (78%) were consultants and 11 (22%) were residents (PGY 3-5). The median scores for the 5 questions were 8.5 (Q1; IQR 8-9), 8 (Q2; IQR 7-9), 9 (Q3; IQR 8-10), 9 (Q4; IQR 8-10), and 9 (Q5; IQR 8-10). Overall, the model was most appreciated by young trainees even though positive responses were also provided by senior surgeons.
We introduce a new beating-heart filled-vessel cadaveric model to simulate VATS lobectomies. From this initial experience, the model is cost effective, smooth to develop, and realistic for VATS simulation.
如今，电视辅助胸腔镜手术（VATS）肺叶切除术已成为早期肺癌的首选治疗方法。多年来，VATS 培训方法不断发展。本研究旨在介绍一种新的模拟 VATS 肺叶切除术的创新搏动心脏填充血管尸体模型。
通过选择性心腔插管，将凝胶填充到肺动脉中，以改善触觉反馈。然后，在气管导管的尖端充气一个气球，使心脏腔室移动，将最小的血流传输到肺动脉。在模拟的手术室中，使用通常在活体患者手术中使用的所有仪器，由经验丰富的外科医生对学员进行持续指导。在每次模拟结束时，参与者被要求就培训方法的有效性回答 5 个 1 到 10 的问题（“1”表示无效，“10”表示非常有效）。
共建立了 8 个模型，每个模型的中位时间为 108 分钟，成本为 1500 欧元。共有 50 名外科医生参与，其中 39 名（78%）为顾问，11 名（22%）为住院医师（PGY3-5）。5 个问题的中位数评分分别为 8.5（Q1；IQR8-9）、8（Q2；IQR7-9）、9（Q3；IQR8-10）、9（Q4；IQR8-10）和 9（Q5；IQR8-10）。总体而言，该模型受到年轻学员的高度赞赏，尽管资深外科医生也给予了积极的反馈。
我们引入了一种新的搏动心脏填充血管尸体模型，以模拟 VATS 肺叶切除术。根据初步经验，该模型具有成本效益、易于开发，并且是 VATS 模拟的理想选择。
