Swine model for training surgeons in minimally invasive anatomic lung segmentectomy.

Abstract

Despite the increasing demand for thoracoscopic lung segmentectomy, the appropriate training method is not well established. Therefore, we developed a swine model for anatomical thoracoscopic lung segmentectomy training. Three-month-old pigs, weighing 40 to 45 kg, were used in this model. Anterior segmentectomy of the left cranial lobe and segmentectomy of the most anterior left caudal lobe were performed under general anesthesia and differential ventilation. Participants from several institutions participated in this program, which included training lectures and surgical skill drills. From 2010 to 2015, 33 pigs were used for the lung segmentectomy training with 51 trainees. Eight pigs were operated on using the hybrid approach, and 25 pigs were operated on using the complete thoracoscopic approach. Among 25 pigs in which the complete thoracoscopic approach was used, conversion to thoracotomy was required in 3 pigs, owing to hemorrhage in two and failure of differential ventilation in one. The no-touch method in supine position provided sufficient intersegmental delineation of 20 (76%) planes among 26 left anterior segmentectomies in the cranial lobe. Our live swine model of anatomical thoracoscopic lung segmentectomy is considered a good choice for training surgeons on how to perform minimally invasive lung segmentectomy in humans.