Development of a pulsatile, tissue-based, versatile vascular surgery simulation laboratory for resident training.
Ontology highlight
ABSTRACT:
SUBMITTER: Fletcher B
PROVIDER: S-EPMC5765174 | biostudies-literature | 2017 Dec
REPOSITORIES: biostudies-literature
Publications
Development of a pulsatile, tissue-based, versatile vascular surgery simulation laboratory for resident training.
Fletcher Brian B De La Ree Jaime J Drougas James J
Journal of vascular surgery cases and innovative techniques 20171014 4
Simulation in surgery is becoming an important component of surgical education. Training on bench top models has been demonstrated to improve technical skills. The objective of our project was to create a vascular surgery simulation model. The simulation model consists of a platform, artificial blood reservoir, artificial blood, inflow and outflow limbs, electric motor, battery, pulse generator, and cryopreserved vessel. Three different vascular surgery simulation stations were created: carotid ...[more]
Similar Datasets
Project description:The establishment of new surgical methods and techniques is associated with a learning curve which can lead to a higher morbidity and mortality for patients during training. To counteract this problem, within the framework of surgical and endovascular training and to transfer the learning curve from the patients to the simulator, life-like models are used and tested. The benefits of such simulator training have been shown in multiple disciplines. This article presents the steps from the conception to the production and validation of a simulator for ultrasound-guided arterial and venous puncture. The goal was to develop a cost-efficient high-fidelity simulator that enables ultrasound-guided percutaneous vascular puncture, direct haptic and visual feedback and the use of some percutaneous devices in a manner as complete and life-like as possible. The finished prototype enables an ultrasound-guided puncture of arteries and veins and the model enables the deployment of endovascular devices and closure systems. To be able to provide and carry out a structured training removed from external influences and challenges is in the interest of clinical departments, trainees and ultimately patient safety. Simulation training on life-like models can provide a valuable contribution in this context and represents a welcome supplement to traditional clinical training.
| S-EPMC9427093 | biostudies-literature
Project description:IntroductionRecent advancements in surgical technology, reduced working hours, and training opportunities exacerbated by the COVID-19 pandemic have led to an increase in simulation-based training. Furthermore, a rise in endovascular procedures has led to a requirement for high-fidelity simulators that offer comprehensive feedback. This review aims to identify vascular surgery simulation models and assess their validity and levels of effectiveness (LoE) for each model in order to successfully implement them into current training curricula.MethodsPubMed and EMBASE were searched on January 1, 2021, for full-text English studies on vascular surgery simulators. Eligible articles were given validity ratings based on Messick's modern concept of validity alongside an LoE score according to McGaghie's translational outcomes.ResultsOverall 76 eligible articles validated 34 vascular surgery simulators and training courses for open and endovascular procedures. High validity ratings were achieved across studies for: content (35), response processes (12), the internal structure (5), relations to other variables (57), and consequences (2). Only seven studies achieved an LoE greater than 3/5. Overall, ANGIO Mentor was the most highly validated and effective simulator and was the only simulator to achieve an LoE of 5/5.ConclusionsSimulation-based training in vascular surgery is a continuously developing field with exciting future prospects, demonstrated by the vast number of models and training courses. To effectively integrate simulation models into current vascular surgery curricula and assessments, there is a need for studies to look at trainee skill retention over a longer period of time. A more detailed discussion on cost-effectiveness is also needed.
| S-EPMC9483723 | biostudies-literature
Project description:INTRODUCTION:Constraints on surgical resident training (work-hour mandates, shorter training programs, etc.) and availability of expert surgical educators may limit the acquisition of prosthetic surgical skills. As a result, training courses are being conducted to augment the prosthetic surgery learning experience. AIM:To evaluate the impact of a hands-on cadaver-based teaching program on resident procedural knowledge and procedural confidence with placement of a penile prosthesis. MAIN OUTCOME MEASURE:Changes in procedural knowledge and self-confidence following a focused training program on penile prosthetics. METHODS:As part of the 2017 Society of Urologic Prosthetic Surgeons and the Sexual Medicine Society of North America Annual Meeting, 31 urology residents participated in a simulation lab in prosthetic urology. The lab included didactic lectures and a hands-on cadaveric laboratory. Participants completed surveys before and after the course. Wilcoxon Signed Rank tests for matched pairs were used to compare respondents' pre- and postcourse knowledge (% questions answered correctly) and confidence ratings. Prior implant experience was assessed. RESULTS:31 residents participated in this study. The majority of the participants were 4th- (41.9%) and 5th-year residents (38.7%). Participants showed a significant improvement in procedural knowledge test scores (68.8±13.4 vs 74.2 ± 13.0, P < .05) and self-reported increased median surgical confidence levels (4 vs 3, P value < .001) after completion of the cadaveric course. Subgroup analysis demonstrated that residents with prosthetic surgery experience of <10 cases benefited the most. In addition, improvement in surgical confidence levels observed was greater than the improvement in surgical knowledge. The overall cost of the simulation training course was approximately $1,483 per resident. CONCLUSION:Simulation training in prosthetic surgery seems to improve surgical confidence and knowledge. Further research is needed to better understand the benefits and limitations of simulation training. Lentz AC, Rodríguez D, Davis LG. Simulation training in penile implant surgery: Assessment of surgical confidence and knowledge with cadaveric laboratory training. Sex Med 2018;6:332-338.
| S-EPMC6302135 | biostudies-literature
Project description:Introduction:We sought to evaluate pediatric oncology simulations intended to improve pediatric residents' skills and comfort in caring for children with cancer. Method:In a non-randomized trial, controls (the first three rotations) received a standard set of lectures, and the intervention arm received these lectures plus five simulation-training scenarios-fever/neutropenia, a new leukemia diagnosis, end-of-life care discussion, tumor lysis syndrome, and a mediastinal mass. All residents were tested after the rotation on the first three scenarios; management skills were evaluated independently by two raters. Before and after training, all residents completed an emotional-appraisal questionnaire evaluating each scenario as a perceived challenge or threat. Analysis of variance (ANOVA) measured differences by study arm in skills-checklist assessments and appraisals; repeated-measures ANOVA measured changes in emotional-appraisal scores. Results:Forty-two residents (9 control, 33 intervention) participated. Inter-rater agreement for skills-checklist scores using average-measures intraclass correlation was high (0.847), and overall mean scores were significantly higher for the intervention than control group across both raters (P = 0.005). For all residents, perceived challenge increased in the end-of-life simulation, and perceived threat decreased in all three test scenarios. The intervention group, regardless of training year, evaluated the teaching scenarios favorably and felt that challenging oncology situations were addressed, skills were enhanced, and the simulations should be offered to other residents. Conclusions:It was feasible to introduce residents to difficult pediatric oncology scenarios using simulation. The intervention group performed more skills than controls when tested, and perceive threat declined in all residents after their pediatric oncology rotation.
| S-EPMC6724731 | biostudies-literature
Project description:ObjectiveWe sought to develop a simulation model to train resident physicians in the performance of a median sternotomy.MethodsA modified Delphi consensus process was used with cardiac surgery staff to develop a 20-point checklist for the safe performance of a median sternotomy. Thirteen junior cardiac surgery trainees from across Canada participated in this study to assess the simulation model. Trainees performed the sternotomy before and after reviewing an instructional video. Two senior cardiac surgery resident physicians assessed the participants with the checklist during each session. An entry and exit questionnaire was given to the participants to evaluate the simulation model.ResultsParticipants scored higher after the training (14.3 ± 2.0) compared with before training (8.0 ± 3.1) (P < .001). The mean duration of time for participants to complete the sternotomy was shorter before training (188 ± 52 seconds vs 228 ± 58 seconds; P = .003). The checklist interrater reliability was κ = 0.47 (moderate) for before training and κ = 0.37 (fair) for after training. All study participants rated the simulation sessions as very useful or extremely useful.ConclusionsUsing the simulation model, training video, and checklist, trainees were able to improve their skill in performing a median sternotomy. This improvement was associated with longer times to complete all procedure steps. Rater training may further improve interrater reliability. Our median sternotomy checklist and simulation model can be adopted for the technical skills training of future cardiac surgery trainees.
| S-EPMC8298924 | biostudies-literature
Project description:The use of 3D-printed models in simulation-based training and planning for vascular surgery is gaining interest. This study aims to provide an overview of the current applications of 3D-printing technologies in vascular surgery. We performed a systematic review by searching four databases: PubMed, Web of Science, Scopus, and Cochrane Library (last search: 1 March 2024). We included studies considering the treatment of vascular stenotic/occlusive or aneurysmal diseases. We included papers that reported the outcome of applications of 3D-printed models, excluding case reports or very limited case series (≤5 printed models or tests/simulations). Finally, 22 studies were included and analyzed. Computed tomography angiography (CTA) was the primary diagnostic method used to obtain the images serving as the basis for generating the 3D-printed models. Processing the CTA data involved the use of medical imaging software; 3DSlicer (Brigham and Women's Hospital, Harvard University, Boston, MA), ITK-Snap, and Mimics (Materialise NV, Leuven, Belgium) were the most frequently used. Autodesk Meshmixer (San Francisco, CA, USA) and 3-matic (Materialise NV, Leuven, Belgium) were the most frequently employed mesh-editing software during the post-processing phase. PolyJet™, fused deposition modeling (FDM), and stereolithography (SLA) were the most frequently employed 3D-printing technologies. Planning and training with 3D-printed models seem to enhance physicians' confidence and performance levels by up to 40% and lead to a reduction in the procedure time and contrast volume usage to varying extents.
| S-EPMC11312310 | biostudies-literature
Project description:BackgroundIncreasing technico-manual complexity of procedures and time constraints necessitates effective neurosurgical training. For this purpose, both screen- and model-based simulations are under investigation. Approaches including 3D printed brains, gelatin composite models, and virtual environments have already been published. However, quality of brain surgery simulation is limited due to discrepancies in visual and haptic experience. Similarly, virtual training scenarios are still lacking sufficient real-world resemblance. In this study, we introduce a novel simulator for realistic neurosurgical training that combines real brain tissue with 3D printing and augmented reality.MethodsBased on a human CT scan, a skull base and skullcap were 3D printed and equipped with an artificial dura mater. The cerebral hemispheres of a calf's brain were placed in the convexity of the skullcap and tumor masses composed of aspic, water, and fluorescein were injected in the brain. The skullcap and skull base were placed on each other, glued together, and filled up with an aspic water solution for brain fixation. Then, four surgical scenarios were performed in the operating room as follows: (1) simple tumor resection, (2) complex tumor resection, (3) navigated biopsy via burr hole trepanation, and (4) retrosigmoidal craniotomy. Neuronavigation, augmented reality, fluorescence, and ocular-as well as screen-based (exoscopic)-surgery were available for the simulator training. A total of 29 participants performed at least one training scenario of the simulator and completed a 5-item Likert-like questionnaire as well as qualitative interviews. The questionnaire assessed the realism of the tumor model, skull, and brain tissue as well as the capability for training purposes.ResultsVisual and sensory realism of the skull and brain tissue were rated,"very good," while the sensory and visual realism of the tumor model were rated "good." Both overall satisfaction with the model and eligibility of the microscope and neurosurgical instruments for training purposes were rated with "very good." However, small size of the calf's brain, its limited shelf life, and the inability to simulate bleedings due to the lack of perfusion were significant drawbacks.ConclusionThe combination of 3D printing and real brain tissue provided surgical scenarios with very good real-life resemblance. This novel neurosurgical model features a versatile setup for surgical skill training and allows for efficient training of technological support like image and fluorescence guidance, exoscopic surgery, and robotic technology.
| S-EPMC7360639 | biostudies-literature
Project description:BackgroundEndoscopic skull base surgery (ESBS) is complex, requiring methodical and unremitting surgical training. Herein, we describe the development and evaluation of a novel three-dimensional (3D) printed simulation model for ESBS. We further validate the efficacy of this model as educational support in neurosurgical training.MethodsA patient-specific 3D printed simulation model using living human imaging data was established and evaluated in a task-based hands-on dissection program. Endoscopic endonasal and transorbital procedures were simulated on the model by neurosurgeons and otorhinolaryngology surgeons of varying experience. All procedures were recorded using a high-definition camera coupled with digital video recorder system. The participants were asked to complete a post-procedure questionnaire to validate the efficacy of the model.ResultsFourteen experts and 22 trainees participated in simulations, and the 32 participants completed the post-procedure survey. The anatomical realism was scored as 4.0/5.0. The participants rated the model as helpful in hand-eye coordination training (4.7/5.0) and improving surgical skills (4.6/5.0) for ESBS. All participants believed that the model was useful as educational support for trainees (4.7 [ ± 0.5]). However, the color (3.6/5.0) and soft tissue feedback parameters (2.8/5) scored low.ConclusionThis study shows that high-resolution 3D printed skull base models for ESBS can be generated with high anatomical accuracy and acceptable haptic feedback. The simulation program of ESBS using this model may be supplemental or provide an alternative training platform to cadaveric dissection.
| S-EPMC9389537 | biostudies-literature
Project description:BackgroundThe purpose of this study was to perform a systematic review of the current literature on simulator-based training in vitreoretinal surgery (VRS). We examined the results regarding simulated VRS and provided an overview of how the current results may be employed in VRS training. Lastly, we evaluated the quality of these results.MethodsThe databases of Pubmed, Embase and Cochrane Library were searched for articles in English involving simulated VRS training. A qualitative analysis was performed, since the studies which met our inclusion criteria did not allow for a quantitative meta-analysis.ResultsWe identified 203 articles of which seven met the inclusion criteria. Of these, six studies investigated simulation with EyeSi® Surgical (VRMagic, Mannheim, Germany). Six studies reported positive performance curves. Four studies showed construct validity. One study attempted to show skill transfer from simulator to vitrectomies performed on cadavers. Methodological quality of the included studies was moderate but lacking in instrument validation.ConclusionSimulator-based training in VRS can assess and possibly assist acquisition of a variety of VRS skills. Further research is needed to support transfer from simulator to operating room. Future studies should strive to follow established validation frameworks and streamline study designs.
| S-EPMC6460826 | biostudies-literature
Project description:Introduction Shifting the training from the operating room (OR) to simulation models has been proven effective in enhancing patient safety and reducing the learning time to achieve competency and increase the operative efficiency. Currently the field of pediatric surgery only offers few low-cost trainers for specialized training and these feature predominantly artificial and often unrealistic tissue. The aim of this study was to develop an easy access low-cost tissue-realistic simulation model for open training of esophageal atresia and to evaluate the acceptance in trainees and junior pediatric surgeons. Materials and methods The model is fashioned using reconfigured chicken skin from a chicken leg. To create a model of esophageal atresia, the chicken skin is dissected off the muscle and reconfigured around a foley catheter balloon to recreate the proximal pouch and a feeding tube to recreate the distal pouch. Surrounding structures such as the tracheo-esophageal fistula and the azygos vein can be easily added, obtaining a realistic esophageal atresia (Type C) prototype. Evaluation of model construction, usage and impact on user were performed by both a self-assessment questionnaire with pre- and post-training questions as well as observer-based variables and a revised Objective Structured Assessment of Technical Skills (OSATS) score. Results A total of 10 participants were constructing and using the model at two different timepoints. OSATS score for overall performance was significantly higher (p = 0.005, z = −2.78) during the second observational period [median (MD): 4,95% confidence interval CI: 3.4, 5.1] compared to the first (MD: 3, 95% CI 2.4, 4.1). Self-reported boost in confidence after model usage for performing future esophageal atresia (EA) repair and bowel anastomosis (BA) in general was significantly higher (EA: U = 1, z = −2.3, p = 0.021, BA: U = 1, z = −2.41, p = 0.016) in participants with more years in training/attending status (EA MD:5, BA MD: 5.5) compared to less experienced participants (EA MD: 1.5, BA: 1). Conclusion Our easy access low-cost simulation model represents a feasible and tissue realistic training option to increase surgical performance of pediatric surgical trainees outside the OR.
| S-EPMC9468334 | biostudies-literature