Stepwise approach for acquisition of microsurgical skills through rat orthotopic liver transplantation experiments
Stepwise approach for acquisition of microsurgical skills through rat orthotopic liver transplantation experiments
复制标题
通过大鼠原位肝移植实验逐步获得显微外科技能
DOI：
10.1159/000528092
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发表时间：
2022
影响因子：
1.6
通讯作者：
Hatano Etsuro
中科院分区：
文献类型：
--
作者：
Hirata Masaaki;Yagi Shintaro;Ito Takashi;Masano Yuki;Okumura Shinya;Yao Siyuan;Miyachi Yosuke;Aoki Hikaru;Katano Kaoru;Hatano Etsuro
尽管大鼠肝移植（LT）对于培训外科医生进行显微外科手术很有用，但掌握这些手术技术仍然很困难。需要能够在短时间内学习适当技能的系统化培训方案。本研究描述了一种有效的五步大鼠 LT 训练方案，外科医生旨在通过持续训练在 3 个月内掌握。第一步是通过观看大鼠 LT 的完整视频来回顾所有程序，并观看熟练外科医生进行的实际 LT 手术，从而能够识别大鼠腹部器官的解剖结构。第二步是进行十次供体手术，包括离体移植物准备，以学习无创伤且精细的技术。第三步是进行十次 LT，目标是实现无肝时间 < 20 分钟并存活到第二天。第四步是进行十次额外的 LT，目标是实现 7 天的生存。第五步是再进行5-10次LT，目标是在连续5次LT手术中实现7天的生存。人们发现，培训的系统化可以提高培训的效率。此外，提前确定具体的操作次数有助于保持训练动力。掌握高效的大鼠 LT 不仅可以提高临床前研究的成功率，还可以使年轻的外科医生更好地在显微镜下对人体进行血管吻合。
Although rat liver transplantation (LT) is useful in training surgeons to perform microsurgery, mastering these surgical techniques remains difficult. Systematized training protocols that enable learning of the proper skills in a short period of time are needed. The present study describes an efficient five-step rat LT training protocol for surgeons designed to be mastered within 3 months through continuous training. The first step was to review all procedures by watching full videos of rat LT and to watch actual LT operations performed by a skilled surgeon, enabling recognition of the anatomy of rat abdominal organs. The second step was to perform ten donor operations, including ex vivo graft preparation, to learn the atraumatic and delicate techniques. The third step was to perform ten LTs, with the goal of achieving an anhepatic time< 20 min and surviving until the next day. The fourth step was to perform ten additional LTs, with the goal of achieving 7 days of survival. The fifth step was to perform 5–10 more LTs, with the goal of achieving 7 days of survival in five consecutive LT operations. Systematizing the training was found to increase its efficiency. Furthermore, determining the specific number of operations in advance is useful to maintain motivation for training. Mastering efficient rat LT will not only enhance the success of preclinical research but will enable young surgeons to better perform vascular anastomoses under a microscope in humans.