Pinar Sedat Alp, Morrow Joseph J, Kong Chia Yew
Academic Unit of Surgery, Glasgow Royal Infirmary and University of Glasgow, New Lister Building, Glasgow, G31 2ER, UK.
Anat Sci Int. 2025 Jul 17. doi: 10.1007/s12565-025-00872-z.
While laparoscopy has become the gold standard for many abdominal surgical procedures, it has a steeper learning curve compared to an open surgical approach. Body donor (cadaveric) models (BDM) present a high-fidelity model for laparoscopic surgical training. There are a variety of models available from fresh-frozen models to soft-embalmed models using multiple proprietary preparation solutions. There remains uncertainty surrounding the models' relative strengths and weaknesses. This study aims to evaluate the different body donor models used in postgraduate laparoscopic surgical training. A systematic search was conducted across Medline, Embase, ClinicalTrials.gov, and Cochrane to identify articles relevant to postgraduate laparoscopic training using HBD following the PRISMA guidelines. A narrative review themed on HBD feasibility, validity, and educational utility in laparoscopic surgical training. PROSPERO Registration: NIHR CRD42023437230. Fifty-five studies were included. BDM in general were perceived as authentic and of high educational value. Soft embalmed models (e.g., Thiel, Genelyn, modified Larssen), were reported to be feasible and possess high face validity despite embalming and had advantages over fresh frozen body donors (FFBDs), including reusability, cost-effectiveness, and better odor satisfaction. Comparative studies reported a preference of human body donor models over other simulation methods due to its high fidelity. Body donor models including soft embalmed models provide high-fidelity laparoscopic training environments well perceived by trainees regardless of preservation or tissue fixation. Significant research gaps remain; head-to-head comparative studies between the different models remain sparse as well as data on non-educational aspects such as formal cost-utility analysis and ecological impact.
虽然腹腔镜检查已成为许多腹部外科手术的金标准，但与开放手术方法相比，其学习曲线更为陡峭。尸体供体模型（BDM）为腹腔镜手术训练提供了一种高保真模型。有多种模型可供选择，从新鲜冷冻模型到使用多种专利制备溶液的软防腐模型。这些模型的相对优缺点仍存在不确定性。本研究旨在评估研究生腹腔镜手术训练中使用的不同尸体供体模型。按照PRISMA指南，在Medline、Embase、ClinicalTrials.gov和Cochrane上进行了系统检索，以识别与使用人体尸体供体进行研究生腹腔镜训练相关的文章。对人体尸体供体在腹腔镜手术训练中的可行性、有效性和教育实用性进行了叙述性综述。PROSPERO注册号：NIHR CRD42023437230。纳入了55项研究。总体而言，尸体供体模型被认为是真实的且具有很高的教育价值。据报道，软防腐模型（如蒂尔模型、Genelyn模型、改良拉尔森模型）尽管经过防腐处理，但仍可行且具有较高的表面效度，并且比新鲜冷冻尸体供体（FFBDs）具有优势，包括可重复使用性、成本效益和更好的气味满意度。比较研究报告称，由于其高保真度，人体尸体供体模型比其他模拟方法更受青睐。包括软防腐模型在内的尸体供体模型提供了高保真的腹腔镜训练环境，无论保存或组织固定情况如何，学员都对其评价很高。仍存在重大研究空白；不同模型之间的直接比较研究仍然很少，关于正式成本效用分析和生态影响等非教育方面的数据也很少。
