Simulation of plastic surgery and microvascular procedures using perfused fresh human cadavers

Carey, Joseph N.; Rommer, Elizabeth; Sheckter, Clifford C.; Minneti, Michael; Talving, Peep; Wong, Alex K.; Garner, W.L.; Urata, Mark M.

doi:10.1016/j.bjps.2013.09.026

Cited by 82 publications

(56 citation statements)

References 12 publications

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“…Though laparoscopic techniques have replaced many conventional operations, open procedures remain prevalent in many surgical fields, including plastic surgery. For this reason, we have developed a cadaveric simulation laboratory to supplement classic, patient-based learning in our residency program (13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

Preoperative surgical rehearsal using cadaveric fresh tissue surgical simulation increases resident operative confidence

et al. 2017

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Background: Rehearsal is an essential part of mastering any technical skill. The efficacy of surgical rehearsal is currently limited by low fidelity simulation models. Fresh cadaver models, however, offer maximal surgical simulation. We hypothesize that preoperative surgical rehearsal using fresh tissue surgical simulation will improve resident confidence and serve as an important adjunct to current training methods.Methods: Preoperative rehearsal of surgical procedures was performed by plastic surgery residents using fresh cadavers in a simulated operative environment. Rehearsal was designed to mimic the clinical operation, complete with a surgical technician to assist. A retrospective, web-based survey was used to assess resident perception of pre-and post-procedure confidence, preparation, technique, speed, safety, and anatomical knowledge on a 5-point scale (1= not confident, 5= very confident).Results: Twenty-six rehearsals were performed by 9 residents (PGY 1-7) an average of 4.7±2.1 days prior to performance of the scheduled operation. Surveys demonstrated a median pre-simulation confidence score of 2 and a post-rehearsal score of 4 (P<0.01). The perceived improvement in confidence and performance was greatest when simulation was performed within 3 days of the scheduled case. All residents felt that cadaveric simulation was better than standard preparation methods of self-directed reading or discussion with other surgeons. All residents believed that their technique, speed, safety, and anatomical knowledge improved as a result of simulation.Conclusions: Fresh tissue-based preoperative surgical rehearsal was effectively implemented in the residency program. Resident confidence and perception of technique improved. Survey results suggest that cadaveric simulation is beneficial for all levels of residents. We believe that implementation of preoperative surgical rehearsal is an effective adjunct to surgical training at all skill levels in the current environment of decreased work hours.

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Section: Introductionmentioning

confidence: 99%

Preoperative surgical rehearsal using cadaveric fresh tissue surgical simulation increases resident operative confidence

et al. 2017

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“…Fresh cadaveric tissue is the gold standard for surgical simulation because of its approximation to living tissue (25). Unlike animal models, cadavers correctly simulate the actual anatomic structures encountered in the operating room.…”

Section: Cadaversmentioning

confidence: 99%

“…Although this form of simulation uses dead tissue and thus cannot faithfully emulate all physiological conditions, some cadaveric surgical courses have utilized pressurized systems to perfuse cadaveric tissues with blood. Perfusing cadaveric tissue creates high-fidelity models for vascular, microvascular and trauma surgery (25)(26)(27)(28). Additionally, cadavers have been used for training flap coverage techniques as well as various endoscopic and laparoscopic operations (29,30).…”

Section: Cadaversmentioning

confidence: 99%

Innovations in surgery simulation: a review of past, current and future techniques

Badash¹,

Burtt²,

Solorzano³

et al. 2016

Ann. Transl. Med.

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261

165

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As a result of recent work-hours limitations and concerns for patient safety, innovations in extraclinical surgical simulation have become a desired part of residency education. Current simulation models, including cadaveric, animal, bench-top, virtual reality (VR) and robotic simulators are increasingly used in surgical training programs. Advances in telesurgery, three-dimensional (3D) printing, and the incorporation of patient-specific anatomy are paving the way for simulators to become integral components of medical training in the future.Evidence from the literature highlights the benefits of including simulations in surgical training; skills acquired through simulations translate into improvements in operating room performance. Moreover, simulations are rapidly incorporating new medical technologies and offer increasingly high-fidelity recreations of procedures. As a result, both novice and expert surgeons are able to benefit from their use. As dedicated, structured curricula are developed that incorporate simulations into daily resident training, simulated surgeries will strengthen the surgeon's skill set, decrease hospital costs, and improve patient outcomes.

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“…Examples of alternative training methods include inanimate models (Auer, 1994;Olsen et al, 1996;Griffon et al, 2000), virtual reality training (Larsen et al, 2012), videos (Smeak et al, 1994;Jukes and Chiuia, 2003), organ models (Szinicz et al, 1994;Sroka et al, 2012), and cadaver-based training (Carpenter et al, 1991;Silva et al, 2004Silva et al, , 2007Mathews et al, 2010;Carey et al, 2013). Limited availability, differences in tissue texture and consistency and the lack of bleeding are often seen as limitations of surgical training in cadavers (Blaschko et al, 2007;Reed et al, 2009;Mitchell et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Bleeding simulation in embalmed cadavers: bridging the gap between simulation and live surgery

Souza

Matera

2015

ALTEX

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SummaryIn veterinary medicine, surgical education and training require the development of abilities that can be acquired in practical classes using currently available models such as cadaver training. Limited availability of cadavers, undesirable changes in tissue texture and the absence of bleeding are the main disadvantages of cadaver-based training compared to training in live animals. This study proposes a chemical cadaver preservation method aimed at overcoming the aforementioned limitations. Blood circulation could be reproduced in preserved cadavers, thereby enabling satisfactory simulation-based training of several surgical procedures, from incision to suture and including hemostatic techniques. The model in this study introduces a high-fidelity simulation training alternative to prepare students for the practice of surgery. In this manner, surgical interventions would be restricted to surgical cases and healthy animals would not be submitted to surgical procedures exclusively for learning purposes.

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Simulation of plastic surgery and microvascular procedures using perfused fresh human cadavers

Cited by 82 publications

References 12 publications

Preoperative surgical rehearsal using cadaveric fresh tissue surgical simulation increases resident operative confidence

Preoperative surgical rehearsal using cadaveric fresh tissue surgical simulation increases resident operative confidence

Innovations in surgery simulation: a review of past, current and future techniques

Bleeding simulation in embalmed cadavers: bridging the gap between simulation and live surgery

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