M Heinrich1, N Tillo, H-J Kirlum, H Till. 1. Department of Paediatric Surgery, University of Munich, Dr. v. Haunersches Kinderspital, Lindwurmstrasse 4, 80337 Munich, Germany. martina.heinrich@med.uni-muenchen.de
Abstract
BACKGROUND:Minimally invasive surgery in small children and infants requires special skills and training. This experimental study compares the efficiency of an in vitro pelvic trainer (PT) and an a in vivo animal model (AM). METHODS: For this study, 12 residents were prospectively randomized into two groups. Initially, all had to pass a basic skill assessment (3 tasks). Then endoscopic small bowel biopsy was performed (8 times) either with the in vitro PT (group A) or the in vivo AM (group B). Finally, all had to demonstrate this procedure in the in vivo AM and repeat the basic skill assessment. A quality index (complications, suture, biopsy) was evaluated. RESULTS: Initially, there was no difference between the two groups. Interestingly, the mean regression gradient of the index for the in vitro PT (group A) was significantly better than for the in vivo AM (group B). In the final in vivo operation, however, the mean index for the in vitro PT (group A) worsened significantly, whereas it increased for the in vivo AM (group B) (p = 0.037). CONCLUSION: Adequate training for an isolated mechanical task such as gut biopsy can be supplied using a pelvic trainer or animal model with similar effects. However in vivo performance of the same task requires secondary surgical skills, which are conveyed during live training with greater success. Consequently, stepwise teaching with both modules seems reasonable before these procedures are approached in neonates or small children.
RCT Entities:
BACKGROUND: Minimally invasive surgery in small children and infants requires special skills and training. This experimental study compares the efficiency of an in vitro pelvic trainer (PT) and an a in vivo animal model (AM). METHODS: For this study, 12 residents were prospectively randomized into two groups. Initially, all had to pass a basic skill assessment (3 tasks). Then endoscopic small bowel biopsy was performed (8 times) either with the in vitro PT (group A) or the in vivo AM (group B). Finally, all had to demonstrate this procedure in the in vivo AM and repeat the basic skill assessment. A quality index (complications, suture, biopsy) was evaluated. RESULTS: Initially, there was no difference between the two groups. Interestingly, the mean regression gradient of the index for the in vitro PT (group A) was significantly better than for the in vivo AM (group B). In the final in vivo operation, however, the mean index for the in vitro PT (group A) worsened significantly, whereas it increased for the in vivo AM (group B) (p = 0.037). CONCLUSION: Adequate training for an isolated mechanical task such as gut biopsy can be supplied using a pelvic trainer or animal model with similar effects. However in vivo performance of the same task requires secondary surgical skills, which are conveyed during live training with greater success. Consequently, stepwise teaching with both modules seems reasonable before these procedures are approached in neonates or small children.
Authors: D J Scott; P C Bergen; R V Rege; R Laycock; S T Tesfay; R J Valentine; D M Euhus; D R Jeyarajah; W M Thompson; D B Jones Journal: J Am Coll Surg Date: 2000-09 Impact factor: 6.113
Authors: C E Scott-Conner; T J Hall; B L Anglin; F F Muakkassa; G V Poole; A R Thompson; P B Wilton Journal: Surg Endosc Date: 1994-09 Impact factor: 4.584
Authors: Ciro Esposito; Maria Escolino; Amulya Saxena; Philippe Montupet; Fabio Chiarenza; Juan De Agustin; Isabela Magdalena Draghici; Mariapina Cerulo; Mario Mendoza Sagaon; Vincenzo Di Benedetto; Piergiorgio Gamba; Alessandro Settimi; Azad Najmaldin Journal: Pediatr Surg Int Date: 2015-02-10 Impact factor: 1.827
Authors: Péter Etlinger; Catarina Barroso; Alice Miranda; João Moreira Pinto; Ruben Lamas-Pinheiro; Hélder Ferreira; Pedro Leão; Tamás Kovács; László Juhász; László Sasi Szabó; András Farkas; Péter Vajda; Attila Kálmán; Tibor Géczi; Zsolt Simonka; Tamás Cserni; Miklós Nógrády; Gergely H Fodor; Andrea Szabó; Jorge Correia-Pinto Journal: Surg Endosc Date: 2021-05-17 Impact factor: 4.584