Porcine Aorto-Renal Artery (PARA) model for laparoscopic transcystic common bile duct exploration: the evolution of a training model to meet new clinical needs
| Autor: | Jose Quiñones Sampedro, Lalin Navaratne, James O. Brewer, David Martínez Cecilia, Stephen W. Marchington, Luis Muñoz Bellvis, Alberto Martínez Isla |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Swine medicine.medical_treatment Common bile duct stones Lithotripsy Renal Artery Laparoscopic transcystic common bile duct exploration medicine.artery Animals Humans Medicine Renal artery Laparoscopic training Common Bile Duct Common bile duct exploration Laparoscopic common bile duct exploration Common bile duct business.industry General surgery Reproducibility of Results Structural integrity Porcine Aorta-Renal Artery model Gallstones medicine.disease Choledocholithiasis medicine.anatomical_structure Cholecystectomy Laparoscopic Current practice Original Article Laparoscopy Surgery business |
| Zdroj: | Langenbeck's Archives of Surgery |
| ISSN: | 1435-2451 1435-2443 |
| DOI: | 10.1007/s00423-020-02045-0 |
| Popis: | Background The transcystic approach to laparoscopic common bile duct exploration has gained popularity for the single-stage management of choledocholithiasis with concomitant gallstones. Our team previously described the use of a porcine aorta segment to simulate the common bile duct during laparoscopic skill training. Methods With the advent of the transcystic approach as a contender for the first-line technique of accessing the common bile duct, we present an evolution of the laparoscopic training model using a Porcine Aorta-Renal Artery (PARA) specimen to simulate the structural integrity, dimensions and spatial distribution of both the human cystic and common bile ducts. Results This training model allows the use of a choledochoscope for transcystic exploration of the biliary tree. It combines fidelity and reproducibility required for a simulated training model to offer experience in laparoscopic transcystic common bile duct exploration. Validation of the model was demonstrated by 21 surgeons who completed a questionnaire after performing the simulated procedure. In all sections assessing reliability, face validity and content validity of the model, mean rating scores were between 4 and 5 out of five (good or excellent). Conclusions We present the evolution of an established training model for laparoscopic common bile duct exploration which focusses the attention on the transcystic approach to the common bile duct and the use of lithotripsy techniques. The need for such a model reflects the shift in the current practice of the laparoendoscopic management of choledocholithiasis with concomitant gallstones from transductal to transcystic approach. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink