Abstract
ABSTRACTPurposeTo develop and validate a chest cavity simulator for teaching video-assited thoracic surgery (VATS).MethodsThe first phase of the study consisted of developing a chest cavity simulator. A quasi-experimental study was performed in the second phase, and 25 surgeons and residents participated in a three-stage pulmonary suture experiment. The videos were recorded and timed. Generalized linear regression models for repeated measures were used to analyze the outcome change over time.ResultsThe chest cavity simulator consists of a console simulating the left hemithorax. Among the participants, 96% rated the design, visual aspect, positioning ergonomics, and triangulation of the portals as very good or excellent (face validity). There was a decrease in suturing time in step 1 from 435.7 ± 105 to 355.6 ± 76.8 seconds compared to step 3 (p = 0.001). The evaluation of the simulation effectiveness and performance (content validity) was rated as very good or excellent by 96% ofparticipants. The most experienced surgeon showed significant reduction in procedure time (p = 0.021) (construct validity).ConclusionsThe thoracic cavity simulator is realistic, showing content and construct validity, and can be used in VATS training. The simulation model allowed skill gain in the endoscopic suture.
Highlights
Video-assisted thoracic surgery (VATS) represented a significant advance in thoracic surgery in the second half of the last century, due to advantages such as shorter length of stay in hospital, reduced pain, reduced morbidity and faster return to everyday activities[1,2,3]
A published study on video-assited thoracic surgery (VATS) lobectomy with 1,015 resections for the treatment of lung cancer demonstrated that the three-port technique was safe, reduced morbidity and mortality, in addition to being effective in oncological patients[4]
In the model proposed by Halstead, the skill gain was based on the performance of a large number of procedures in patients[5]
Summary
Video-assisted thoracic surgery (VATS) represented a significant advance in thoracic surgery in the second half of the last century, due to advantages such as shorter length of stay in hospital, reduced pain, reduced morbidity and faster return to everyday activities[1,2,3]. A published study on VATS lobectomy with 1,015 resections for the treatment of lung cancer demonstrated that the three-port technique was safe, reduced morbidity and mortality, in addition to being effective in oncological patients[4]. The simulation training brought skill gains that can be transferred to the operating room, such as performance gain and errors reduction, offering an unlimited number of repetitions and, most importantly, it does not harm the patients during training[6,7,8]. Practicing cannot be understood as weakness, but as synonymous with responsibility and ethics[9]
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