Comparative analysis of the results of video-assisted thoracic surgery lobectomy simulation using the three-dimensional-printed Biotexture wet-lung model and surgeons' experience.

Abstract

We performed a comparative analysis of the performance of video-assisted thoracic surgery (VATS) lobectomy simulation using three-dimensional-printed Biotexture lung models by surgeons classified according to their level of expertise. The aim of this study was to investigate the association between surgeons' experience and time to complete the VATS lobectomy simulation. Participants were divided into 3 groups: group A included those who had no experience of actual VATS lobectomy (n = 11), group B included those who had performed 5-10 VATS lobectomies (n = 12) and group C included those who had performed >100 VATS lobectomies (n = 6). Their performances were assessed based on total procedure time, duration to the exposure of the vessels, ligation of the arteries and stapling of the fissures. After the simulation, a questionnaire survey was performed. The median total procedure time was significantly shorter in the group of surgeons with more experience (A vs B, P < 0.001; B vs C, P = 0.034; A vs C, P < 0.001). Regarding 'the exposure of all the vessels to be resected' and 'ligation of the arteries', group B completed these steps in less time than group A (P = 0.024 and P = 0.012, respectively). In the questionnaire, all groups answered that this simulation was useful for novices to improve their skills. Although time to complete the VATS lobectomy simulation is only a part of evaluation points for real skills, this model can facilitate basic skill acquisitions for novices.