Samankatiwat Piya, Ngodngamthaweesuk Montien
Division of Thoracic Surgery, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Ann Thorac Surg Short Rep. 2023 Jul 12;1(4):701-706. doi: 10.1016/j.atssr.2023.06.007. eCollection 2023 Dec.
The Blalock-Taussig-Thomas shunt is one of the milestone procedures in cardiac surgery and a crucial operation for palliating blue babies. It is currently impractical to train new surgeons on infants even under the supervision of their mentors. A realistic training model for location, exposure, tissue toughness, and texture is required. The objective of this study was to determine whether the model is realistic and practical and to evaluate the quality of anastomosis performed by surgical trainees.
Piglet heart and lung models were selected from piglets of 3 to 5 kg. Six cardiothoracic surgical residents participated in the program and performed the procedure. Subsequently, every trainee answered a standard questionnaire in terms of satisfaction in reality and practicality; the trainers evaluated the quality of the anastomosis. The median score of each item was analyzed and described. The quality of anastomosis was evaluated and analyzed similarly.
Median scores of satisfaction (14 questions) were 9, 10, 9, 9.5, 10, 9.5, 10, 9.5, 10, 8.5, 10, 8.5, 10, and 8. Median challenge scores (6 questions) were 10, 10, 10, 10, 10, 9.5, and 10. The median anastomosis evaluation score from 6 trainees was 25 (24-25).
Our heart-lung simulation model is perhaps 1 of the most realistic simulations in practicality, visualization, exposure of the related structures, similar scenes to the real operation, and sense of touch and texture. Realistic models should be developed, but they should be inexpensive.
布莱洛克 - 陶西格 - 托马斯分流术是心脏外科的里程碑式手术之一,也是缓解蓝婴症状的关键手术。目前,即使在导师的监督下,对新外科医生进行婴儿手术培训也是不切实际的。需要一个针对手术位置、暴露情况、组织韧性和质地的现实培训模型。本研究的目的是确定该模型是否现实可行,并评估外科实习生进行吻合术的质量。
从3至5千克的仔猪中选取猪心和肺模型。六名心胸外科住院医师参与了该项目并实施了手术。随后,每位实习生就现实性和实用性方面的满意度回答了一份标准问卷;培训师评估了吻合术的质量。对每个项目的中位数得分进行了分析和描述。对吻合术的质量也进行了类似的评估和分析。
满意度(14个问题)的中位数得分分别为9、10、9、9.5、10、9.5、10、9.5、10、8.5、10、8.5、10和8。挑战得分中位数(6个问题)为10、10、10、10、10、9.5和10。6名实习生的吻合术评估得分中位数为25(24 - 25)。
我们的心肺模拟模型在实用性、可视化、相关结构的暴露、与实际手术相似的场景以及触觉和质地方面可能是最逼真的模拟模型之一。应开发现实可行的模型,但成本要低。