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Objective: to validate a lumbar spine endoscopic flavectomy simulator using the construct method and to assess the acceptability of the simulator in medical education. Methods: thirty medical students and ten video-assisted surgery experienced orthopedists performed an endoscopic flavectomy procedure in the simulator. Time, look-downs, lost instruments, respect for the stipulated edge of the ligamentum flavum, regularity of the incision, GOALS checklist (Global Operative Assessment of Laparoscopic Skills), and responses to the Likert Scale adapted for this study were analyzed. Results: all variables differed between groups. Procedure time was shorter in the physician group (p < 0.001). Look-downs and instrument losses were seven times greater among students than physicians. Half of the students respected the designated incision limits, compared to 80% of the physicians. In the student group, about 30% of the incisions were regular, compared to 100% in the physician group (p < 0.001). The physicians performed better in all GOALS checklist domains. All the physicians and more than 96% of the students considered the activity enjoyable, and approximately 90% believed that the model was realistic and could contribute to medical education. Conclusions: the simulator could differentiate the groups’ experience level, indicating construct validity, and both groups reported high acceptability.

Introduction: The objective of this study is to describe a model of knee arthroscopy simulator that is affordable, low-cost and easily reproducible, aiming to enable the diffusion of more effective active teaching and training methodologies. Methods: For the creation of the arthroscopic camera, an endoscopic camera for mobile phones and computers model SXT-5.0M manufactured by KKMOON were used. The camera was introduced in a metal tube, which was coupled to a set of three 20 mm PVC hydraulic connectors to simulate the handle and sleeve of the arthroscope. The camera has a resolution of 1280 x 720 pixels and is equipped with six built-in white LED lamps, simulating and eliminating the need to use an additional light source. The knee model was developed using a PVC pipe fixed on a wooden support, to which synthetic femur and tibia models were affixed. Four three-centimeter diameter holes, compatible with the standard arthroscopic portals, were made in the body of the PVC pipe. For the menisci, a model was made out of modeling clay (Corfix®), until the anatomical structures were close to the real ones. The model consists of both menisci and the intercondylar eminence, simulating the proximal tibial articular surface. The model made out of modeling clay was the basis for the production of a thin Crystal Polyester Resin mold. Using the resin mold, the meniscal models were made of Silicone Rubber Type II, widely used in industry and crafts. Results: A functional and reproducible simulator was obtained, consisting of a knee model and an arthroscopic camera. The simulator works adequately adapted to a TV, monitor or computer, and allows the simulation of diagnostic procedures, meniscectomy and meniscoplasty. Conclusion: It is possible to develop a knee arthroscopy simulator, with components available in local and electronic commerce, at a cost of approximately R$ 300.

ResumoA primeira sutura meniscal foi realizada em 1885 e levou cerca de um século para tornar-se popular. Atualmente, os dispositivos de reparo meniscal all-inside são amplamente utilizados. Contudo, esta técnica apresenta a desvantagem de ser um método dependente de dispositivos específicos, apresentando um custo superior aos de outras técnicas. Este valor elevado limita o uso de tal técnica em muitos locais. O objetivo da presente nota técnica é descrever uma técnica de sutura meniscal microinvasiva, como uma modificação da técnica all-inside, utilizando uma agulha descartável de procedimento de 40 × 12 mm. Os autores acreditam que a modificação proposta para a técnica pode torná-la mais popular, possibilitando o uso da técnica microinvasiva em locais com recursos limitados.

ResumoO objetivo do presente trabalho é criar um modelo de treinamento em artroscopia de ombro de baixo custo abaixo de 100 dólares, tornando-o acessível à capacitação prática de estudantes de medicina e residentes. O modelo foi criado utilizando um cano de PVC de 150 mm de diâmetro em 90 graus e um modelo de ombro sintético. O posicionamento das peças foi disposto de forma a simular a posição de decúbito lateral com membro superior em tração, frequente nas artroscopias. Para auxiliar no treinamento, foram demarcados pontos coloridos na glenóide e foi confeccionado um modelo de parte do manguito rotador na porção superior da escápula. Foi possível confeccionar um modelo para treinamento de artroscopia do ombro com um valor abaixo de 100 dólares, de fácil manufatura, que pode ser um auxiliar no treinamento de cirurgiões.