Assessment of laparoscopic training for gynecological malignancies using Thiel‑embalmed human cadavers

Abstract

The introduction of laparoscopic surgery has also been beneficial for patients with gynecological malignancies. In this respect, surgeons should receive related training in the context of human resource development. Hands-on training was introduced using Thiel-embalmed human cadavers (THCs) in 2014. To determine the usefulness of THCs, they were evaluated in terms of tissue color, consistency and operative tactility, among others, compared with in vivo laparoscopic training for gynecological malignancies. Hands-on training sessions using THCs were held for a total of 11 times at Ehime University Graduate School of Medicine between March 2014 and October 2017. Training on THCs included advanced laparoscopic procedures for radical hysterectomy type III. At the end of each training session, data were collected using a standardized, anonymous questionnaire termed the Likert scale. THCs ensured flexibility and plasticity of tissues and organs; therefore, the working space was similar to that in the living body under pneumoperitoneum. After analyzing the quality and consistency of tissue and organ color compared with in vivo conditions, most of the participants agreed or strongly agreed regarding the uterus, adnexa and ureter, but not regarding the large blood vessels. The highest scores were observed in the authenticity of the anatomical condition of each organ. Most participants strongly agreed that training using THCs would help improve their laparoscopic skills with a high level of satisfaction. Furthermore, most participants reported that they would recommend this training to other obstetrician-gynecologists. Laparoscopic training for gynecological malignancies using THCs was comparable to the in vivo conditions in terms of surgical view and operative tactility. Therefore, THCs may be an excellent training tool for improving laparoscopic surgical skills for gynecological malignancies.

Establishment and evaluation of a training course in advanced laparoscopic surgery based on human body donors embalmed by ethanol-glycerol-lysoformin fixation

“…Indeed, most participants in our courses had attended other training courses and had significant clinical experience. However, a standardized documentation of the participants’ previous training experience and skills has not been carried out in detail in previous studies [ 29 , 30 , 42 ] and so we cannot compare our findings with other studies. Thus, it is not possible to state whether the low training effect regarding laparoscopic suturing techniques is due to the participants being already proficient in suturing, the specific set-up of our training course, or to the conditions of the body donors.…”

“…Undoubtedly, both Thiel´s embalming method and fresh-frozen body donors provide good tissue properties and a realistic setting [ 25 – 27 , 29 ]. Compared to fresh-frozen cadavers, advantages of Thiel’s method include low odor nuisance, the option for multiple reuse and no need for expensive deep-freezing facilities and time-consuming defrosting procedures [ 28 , 29 ]. However, these advantages were also achieved by using ethanol-glycerol-lysoformin fixation, e.g., low odor, optional reuse, and easy storage [ 17 ].…”

Surgical training in video-assisted neck surgery-based thyroidectomy using fresh frozen human cadavers

“…Endoscopic surgery requires different skills from conventional surgery, and training programs that allow surgeons to learn such technical skills are needed. Skill-training laboratories and various simulation models have been developed, such as dry box simulators, virtual reality simulators, and animal models (3)(4)(5)(6)(7)(8)(9)(10). In Japan, the publication of the "Guidelines for Cadaver Dissection in Education and Research of Clinical Medicine" in 2012 confirmed that surgical training using cadavers is lawful, providing it is conducted under adequate supervision and appropriate rules (3,6).…”

“…Therefore, some medical universities have started to perform surgical training using human cadaver models (3). Due to their fidelity and anatomy, human cadavers are a useful resource for surgical training (4,(6)(7)(8).…”

Is the Thiel-embalmed cadaver model a good option for colorectal laparoscopic surgery training programs?A survey on trainees and professors

“…The arrival of laparoscopic techniques has created a novel paradigm for surgical training, with a new learning model and a shift towards more structured laparoscopic training programs. Trainees need to acquire and perfection new surgical skills before performing in a patient to guarantee the best quality treatment (1,2).…”