Validation of a thoracoscopic lobectomy simulator†

Tong, Betty C.; Gustafson, Monica; Balderson, Stafford S.; D’Amico, Thomas A.; Meyerson, Shari L.

doi:10.1093/ejcts/ezs012

Cited by 33 publications

(23 citation statements)

References 20 publications

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“…There have been several reports demonstrating the effectiveness of these types of simulators (3,12). However, they require special instruments that account for the heightened risk of contamination and infection.…”

Section: Discussionmentioning

confidence: 99%

Video-assisted thoracoscopic surgery training with a polyvinyl-alcohol hydrogel model mimicking real tissue

Satô

Morikawa

2017

J. Vis. Surg.

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Video-assisted thoracoscopic surgery (VATS) has become increasingly accepted, and the thoracic surgeon must be proficient in this technique. Although the advantages of VATS are widely acknowledged, the procedures are technically challenging and may result in catastrophic complications. Thus, the importance of VATS training has long been recognized and various training simulators are available. In this report, we introduce a training method using a new simulator comprising polyvinyl-alcohol (PVA) hydrogel mimicking real human anatomy and texture.Keywords: Video-assisted thoracoscopic surgery (VATS); minimally invasive thoracic surgery; simulator; training Training of VATS segmentectomyTraining session records of left upper lobe lobectomy (superior segmentectomy) are shown in Figures 5,6. During the procedures, the trainee was able to see through to the inside of the chest cavity to check and understand the optimized direction of the instruments or staplers. In Figure 6, the trainee and the instructor interrupted the procedure and pulled out the model from the rib cage to examine the three-dimensional structure of the vessels and the bronchus. Note that this model provided lung parenchyma that can be resected by electrocautery and energy devices, and also presented an accurate three-dimensional structure that included the division of vessels and bronchi allowing for realistic segmentectomy training. DiscussionThe advantages of VATS over thoracotomy (including reduced perioperative complications and shorter length of stay with equivalent oncologic outcomes) have been recognized for years. Accordingly, the number of VATS lobectomy procedures has doubled in the past decade; approximately 36% of lobectomies in Japan were performed using VATS in 2005, and recent statistics have shown that the figure doubled in 2015 (10,11). Thus, VATS procedures have become a de facto necessary skill for thoracic surgeons to learn.In pulmonary resections, comprehensive understanding of the anatomical structures of pulmonary arteries, veins, and bronchi is essential. These networks intersect each other in a complicated manner, and incomplete fissure may further obscure these structural relationships. In the thoracoscopic setting, the placement, scope, and movement of the instruments are limited because of the patient's hard bony rib cage, which restricts the field of view and perspective. Therefore, training with a simulator that provides a bony rib cage is ideal for addressing these issues.Training systems that use living animals have numerous advantages. Pulsation and the movement of the mediastinum driven by respiration provide realistic sensations. Trainees can also gain experience in tissue incision, dissection, coagulation hemostasis using electrocautery, energy devices, ultrasound devices, as well as actual procedures. In addition, they can learn how to prevent and manage injuries to the vessels and lung parenchyma. The major drawback

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Section: Discussionmentioning

confidence: 99%

Video-assisted thoracoscopic surgery training with a polyvinyl-alcohol hydrogel model mimicking real tissue

Satô

Morikawa

2017

J. Vis. Surg.

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“…The VATS programme is run by two dedicated VATS surgeons who developed a VATS training programme designed to teach a trainee the skills necessary for performing a VATS lobectomy in a safe way. The preparatory phase of the programme included VATS master classes at Elancourt, France, with hands-on practice on live pigs, and a VATS lobectomy course led by Dr Thomas D'Amico at Duke University Hospital, North Carolina, with training on a validated lobectomy model [17]. Observation of VATS lobectomies both on video and on the operating room was mandatory, and minor VATS procedures (wedge resections and operations for pneumothorax) were taught.…”

Section: Methodsmentioning

confidence: 99%

No extensive experience in open procedures is needed to learn lobectomy by video-assisted thoracic surgery

Konge

Petersen

Hansen

et al. 2012

Interactive CardioVascular and Thoracic Surgery

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“…Training programs for such as courses for videothoracoscopic surgery can be seen as a surrogate of pursuing new and better techniques. A number of different teaching techniques have been published in the literature (11,12). We developed an ex vivo model for VATS resections using sheep's lung injected with diluted ketchup for better and realistic dissection teaching experience ( Figure 5) which can provide a safe environment for better and safe learning.…”

Section: Future Prospectivesmentioning

confidence: 99%

Asian perspective in surgery: thoracic surgery in Turkey

Turna¹

2016

J. Thorac. Dis.

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Turkey with a population of 78 million is located between Asia and Europe geographically and culturally. There are 577 active pure thoracic surgeon and 37 thoracic surgery teaching units. Thoracic surgeons usually deal with lung cancer patients due to relatively higher rate of tobacco usage as well as inflammatory diseases such as pulmonary hydatid disease, bronchiectasis and empyema. Minimally invasive thoracic surgery has been a new approach which is being adapted by increasingly more surgeons. There are a number of reasons to predict that the number of thoracic surgical cases will be increased and new generation of thoracic surgeons will be operating more minimally invasive resectional surgeries for most lung cancer in future.

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Validation of a thoracoscopic lobectomy simulator†

Abstract: The thoracoscopic lobectomy simulator used in this study demonstrates acceptable validity and can be a useful tool for teaching thoracoscopic lobectomy to trainees or experienced surgeons.

Cited by 33 publications

References 20 publications

Video-assisted thoracoscopic surgery training with a polyvinyl-alcohol hydrogel model mimicking real tissue

Video-assisted thoracoscopic surgery training with a polyvinyl-alcohol hydrogel model mimicking real tissue

No extensive experience in open procedures is needed to learn lobectomy by video-assisted thoracic surgery

Asian perspective in surgery: thoracic surgery in Turkey

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