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

Ackermann, Johannes; Wedel, Thilo; Hagedorn, Heiko; Maass, Nicolaì; Mettler, Liselotte; Heinze, Tillmann; Alkatout, İbrahim

doi:10.1007/s00464-020-07523-6

Cited by 11 publications

(10 citation statements)

References 41 publications

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“…Simultaneous surgery performed on real patients and body donors was especially appreciated by the participants. The quality and authenticity of the body donors were also considered very realistic, thus confirming previous data about the suitability of ethanol-glycerol-lysoformin fixation for this purpose [16,17]. Moreover, the use of body donors makes it possible to demonstrate the patient's relevant anatomy beyond the limits observed in real patients.…”

Section: Discussionsupporting

confidence: 76%

“…Body donors embalmed in ethanol-glycerol-lysoformin were shown to be particularly suitable for surgical training and education [15][16][17]35]. Based on these previous encouraging experiences, laparoscopy performed on body donors was integrated into the live surgery session at the largest German surgical working group in gynecology (AGE) in order to evaluate the authenticity of this educational approach, its value for surgical training, and its didactic benefits.…”

Section: Discussionmentioning

confidence: 99%

“…One of these techniques is ethanol-glycerol-lysoformin fixation, which is relatively simple and cost effective, and provides realistic tissue and organ properties [15]. We established the suitability of this method for minimally invasive surgical procedures, and demonstrated its didactic benefits for the acquisition and refinement of surgical skills [16,17].…”

Section: Introductionmentioning

confidence: 99%

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Didactic Benefits of Surgery on Body Donors during Live Surgery Events in Minimally Invasive Surgery

Ackermann

Wedel

Holthaus

et al. 2020

JCM

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Background: Live surgery events serve as a valuable tool for surgical education, but also raise ethical concerns about patient safety and professional performance. In the present study, we evaluate the technical feasibility and didactic benefits of live surgery on body donors compared to real patients. Methods: A live surgery session performed on a body donor’s cadaver embalmed in ethanol–glycerol–lysoformin was integrated into the live surgery program presented at a major gynecological convention of minimally invasive surgery. Surgical procedures carried out in real patients were paralleled in the body donor, including the dissection and illustration of surgically relevant anatomical landmarks. A standardized questionnaire was filled by the participants (n = 208) to evaluate the appropriateness, effectiveness, and benefits of this novel concept. Results: The live surgery event was appreciated as a useful educational tool. With regard to the use of body donors, authenticity was rated high (85.5%), and the overall value of body donors for surgical education and training was rated very high (95.0%). The didactic benefit of simultaneous operations performed on body donors and real patients was considered particularly useful (95.5%), whereas complete replacement of real patients by body donors was not favored (14.5%). Conclusions: The study demonstrated both the technical feasibility and didactic benefits of performing minimally invasive surgery in body donors as part of live surgery events. This novel concept has the potential to enhance anatomical knowledge, providing insights into complex surgical procedures, and may serve to overcome yet unresolved ethical concerns related to live surgery events.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Didactic Benefits of Surgery on Body Donors during Live Surgery Events in Minimally Invasive Surgery

Ackermann

Wedel

Holthaus

et al. 2020

JCM

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“…1:1-Betreuung. Viele Trainingsprogramme sind so aufgebaut, dass die zu Trainierenden in Gruppen an Simulatoren geschult werden [6,22,23]…”

Section: Feedback Im Rahmen Des Proctoringsunclassified

Der Stellenwert des Feedbacks beim Proctoring in der robotergestützten Chirurgie – ein Grundstein des Erfolgskonzeptes?

Alkatout

Maass

2023

Zentralbl Chir

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ZusammenfassungRoboterassistierte Operationsmethoden stellen eine Weiterentwicklung und Ergänzung der konventionellen Laparoskopie dar. Somit ist eine entsprechende Ausbildung der Chirurgen in diesem Fachgebiet unabdingbar. Gerade für die Anfangsphase eignen sich Simulationsprogramme – ähnlich wie in der Aviatik – hervorragend, um an das technisch herausfordernde Operationsverfahren heranzuführen. Im weiteren Verlauf, aber noch zu Beginn der Lernkurve, hat sich das Proctoring bewährt, um den zu trainierenden Chirurgen vor Ort zu begleiten, individuell zu schulen und an komplexere Fälle heranzuführen. Ein wesentlicher Baustein erfolgreicher Trainingskonzepte stellt das Feedback dar: Mit etwas zeitlichem Abstand und schriftlich fixiert erhält der zu schulende Chirurg eine Zusammenfassung bzw. einen Leitfaden, der sowohl die bestehende Situation als auch Verbesserungsvorschläge und das Zukunftspotenzial darlegt. Die Umsetzung eines solchen Feedbacks ermöglicht es dem Chirurgen, zusätzlich zur Anzahl an absolvierten Fällen, seine Selbsteinschätzung zu relativieren und Entwicklungsziele anzupassen. Somit stellt das Feedback die entscheidende Schnittstelle zwischen dem Beginn einer Lernkurve und fortgeschrittenen operativen Fähigkeiten inklusive der Möglichkeit einer realistischen Selbsteinschätzung dar.

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“…Currently, no data exists concerning the technical feasibility of the Versius ® robotic system in small cavities. Thus, the aim of this study was to test the Versius ® system on its ability to perform complex reconstructive surgical tasks, best replicated by intracorporal suturing and knot tying, in small boxes simulating pediatric-sized cavities [ 9 , 10 , 11 , 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Versius Robotic Surgical System for Procedures in Small Cavities

et al. 2022

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Background: The Versius® is a recently approved robotic surgical system for general surgery procedures in adults. Before any application in children, data of its feasibility and safety in small cavities has to be compiled, beginning with inanimate models. Therefore, the aim of this preclinical study was to assess the Versius® system for its performance in small boxes simulating small body cavities. Methods: In total, 8 cardboard boxes of decreasing volumes (15.75 L to 106 mL) were used. The procedures, two single stitches with two square knots each, were performed in every box, starting in the largest and consecutively exchanging the box to the next smaller one. The evaluation included procedure time, port placement and pivot point setup, arrangement of the robotic arms and instrumentation, amount of internal and external instrument–instrument collisions and instrument–box collisions. Results: All procedures could be successfully performed in all boxes. The procedure time decreased due to the learning curve in the first four boxes (15.75 to 1.87 L) and consecutively increased from boxes of 1.22 L up to the smallest box with the dimensions of 4.4 × 4.9 × 4.9 cm3. This may be based on the progress of complexity of the procedures in small cavities, which is also depicted by the synchronous increase of the internal instrument–instrument and instrument–box collisions. Conclusion: With the use of the Versius® robotic surgical system, we were able to perform robotic reconstructive procedures, such as intracorporal suturing and knot tying, in cavities as small as 106 mL. Whether this system is comparable or even superior to conventional laparoscopic surgery in small cavities, such as in children, has to be evaluated. Furthermore, before any application in newborns or infants, ongoing evaluation of this system should be performed in a live animal model.

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

Cited by 11 publications

References 41 publications

Didactic Benefits of Surgery on Body Donors during Live Surgery Events in Minimally Invasive Surgery

Didactic Benefits of Surgery on Body Donors during Live Surgery Events in Minimally Invasive Surgery

Der Stellenwert des Feedbacks beim Proctoring in der robotergestützten Chirurgie – ein Grundstein des Erfolgskonzeptes?

Evaluation of the Versius Robotic Surgical System for Procedures in Small Cavities

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