Abstract
ABSTRACTPurposeDevelop a 3D model for the simulation of laparoscopic inguinal hernioplasty transabdominal preperitoneal (TAPP).MethodsThis is an experimental study, 18 participants were selected, divided into three groups, experimental (GE) surgeons in training, control (GC) experienced surgeons and Shaw (GS) nonexperienced surgeons. The simulation in the 3D model was carried out in 6 sessions fulfilling the 5 stages. Opening the peritoneum with the creation of the preperitoneal space; identification of important structures; hernia identification and reduction; placement and fixation of the mesh in Cooper’s ligament and closure of the peritoneum.ResultsIn the 1st stage, the GE obtained an average of 1.25 ± 0.42 in the 1st session and 3.25 ± 0.62 in the 6th session (p = 0.05) and in the 5th stage 0.91 ± 0.29 in the first session. 1st session and 1.91 ± 0.29 in the 6th session (p = 0.001), with no significant difference between groups. The learning and skill curve in the SG represented 1.08 ± 0.29 1st and 3.50 ± 0.90 6th session (p = 0.001).ConclusionsThe creation of a systematization of training in simulation applied to the three-dimensional model enabled gain in laparoscopic skills and underpinned its theoretical and practical foundations.
Highlights
Inguinal hernia is a pathology described as a public health problem due to its prevalence in the adult population[1]
Maurice Arregui described the technique that combined the principles of the French school (STOPPA) with the new minimally invasive approach being named as transabdominal preperitoneal (TAPP)[6]
The sample was characterized by surgeons, divided into three groups, experimental group (EG) surgeons in training, control group (CG) experienced surgeons and Shaw group (SG) surgeons not experienced
Summary
Inguinal hernia is a pathology described as a public health problem due to its prevalence in the adult population[1]. Its prevalence is estimated from 5 to 18% and the incidence reaches from 100 to 300 cases per 100,000 inhabitants yearly worldwide, being the inguinal hernioplasty the most commonly performed abdominal surgery[2,3,4]. The literature describes laparoscopy as an effective approach, reducing cost of painkillers, intraoperative and long-term complications such as seroma, numbness, and pain[7,8,9]. With the spread of knowledge and experience, it was possible to adapt and improve these factors, and with favorable patient performance due to lower metabolic response to trauma, early hospital discharge, rapid return to work, reduced days off due to disability, laparoscopy becomes an effective and efficient method that can provide better patient safety[11,12]
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