Augmentation of Chicken Thigh Model with Fluorescence Imaging Allows for Real-Time, High Fidelity Assessment in Supermicrosurgery Training.
Augmentation of Chicken Thigh Model with Fluorescence Imaging Allows for Real-Time, High Fidelity Assessment in Supermicrosurgery Training.
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使用荧光成像的鸡大腿模型的增强可以在超级外科手术训练中进行实时高保真评估。
DOI：
10.1055/s-0040-1722184
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发表时间：
2021-07
影响因子：
2.1
通讯作者：
Poore, Samuel O.
中科院分区：
文献类型：
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作者：
Albano, Nicholas J.;Zeng, Weifeng;Lin, Christie;Uselmann, Adam J.;Eliceiri, Kevin W.;Poore, Samuel O.
超级显微手术所需的技能来之不易，难以掌握。威斯康星州大学的“蓝血”鸡大腿模型采用了蓝色液体溶液灌注大腿血管，使用户能够可视化流经他们大腿的血流。该模型已被证明是小血管（低至0.3 mm）的良好来源，但在此空间尺度下评估血管质量已被证明是困难的。我们评估了在这个现实的训练模型中使用吲哚菁绿色（ICG）的荧光成像是否会增强超微外科手术的评估，从而改善对受训者的实时反馈。进行直径范围为0.35至0.55 mm的血管吻合术，然后在输注“蓝血”和ICG期间捕获白色光，有或没有荧光成像覆盖。视频被随机分配给威斯康星大学麦迪逊分校的7名接受过研究员培训的显微外科医生，他们将每个吻合术评为“通畅”、“不通畅”或“不确定”。测量了每种成像方式的外科医生准确性、不确定性和评分者间一致性。与仅使用白色光的47%（p = 0.015）相比，使用荧光可将外科医生的准确性显著提高至91%，与仅使用白色光的41%（p = 0.011）相比，将外科医生的不确定性降低至4%，并将评价者间一致性从仅使用白色光的53.1%提高至91.8%（p = 0.016）。当在训练环境中评估超微外科手术时，使用ICG荧光增强威斯康星州大学“蓝血”鸡大腿模型提高了准确性，降低了不确定性，并提高了评估者之间的一致性。这种改进的实时反馈增强了该模型作为超显微手术培训工具的价值。
The skills required for supermicrosurgery are hard-earned and difficult to master. The University of Wisconsin “blue-blood” chicken thigh model incorporates perfusion of the thigh vessels with a blue liquid solution, allowing users to visualize flow across their anastomoses. This model has proven to be an excellent source of small vessels (down to 0.3 mm) but assessing the quality of anastomoses at this spatial scale has proven difficult. We evaluated whether fluorescent imaging with indocyanine green (ICG) in this realistic training model would enhance the assessment of supermicrosurgical anastomoses, and therefore improve real-time feedback to trainees. Anastomoses of vessels ranging from 0.35 to 0.55mm in diameter were performed followed by the capture of white light with and without fluorescence imaging overlay during infusion of “blue-blood” and ICG. Videos were randomized and shown to seven fellowship-trained microsurgeons at the University of Wisconsin-Madison who rated each anastomosis as “patent,” “not patent,” or “unsure.” Surgeon accuracy, uncertainty, and inter-rater agreement were measured for each imaging modality. Use of fluorescence significantly increased surgeon accuracy to 91% compared with 47% with white light alone (p = 0.015), decreased surgeon uncertainty to 4% compared with 41% with white light alone (p = 0.011), and improved inter-rater agreement from 53.1% with white light alone to 91.8% (p = 0.016). Augmentation of the University of Wisconsin “blue-blood” chicken thigh model with ICG fluorescence improves accuracy, decreases uncertainty, and improves inter-rater agreement when assessing supermicrosurgical anastomoses in a training setting. This improved, real-time feedback enhances this model’s value as a supermicrosurgical training tool.
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影响因子：
2.6
作者：
Schoeff, Stephen;Hernandez, Brian;Shonka, David C., Jr.
通讯作者：
Shonka, David C., Jr.
影响因子：
4.1
作者：
Belykh, Evgenii;Lei, Ting;Preul, Mark C.
通讯作者：
Preul, Mark C.
影响因子：
--
作者：
Prunieres, G. J. -C.;Taleb, C.;Facca, S.
通讯作者：
Facca, S.
影响因子：
3.6
作者：
Rodriguez, Jose R.;Yanez, Ricardo;Dagnino, Bruno
通讯作者：
Dagnino, Bruno
影响因子：
2.1
作者：
Costa, Alfio Luca;Cucinotta, Filippo;Colonna, Michele Rosario
通讯作者：
Colonna, Michele Rosario