The avian model: a novel and cost-effective animal tissue model for training in neonatal laparoscopic surgery

Abstract

To design and validate a new and cost-effective animal tissue model for training neonatal minimal access surgery (MAS) skills. A prospective observational study was performed during two Minimally Access Surgery Skill Labs in June 2018 and April 2019. Selected laparoscopic exercises were performed on fresh chicken cadavers using 3 mm MAS instruments (adhesiolysis, cholecystectomy and intestinal anastomosis). Data for validation were collected with a 5-point Likert scale questionnaire based on the Michigan Standard Simulation Experience Scale (MiSSES) and analysis was performed. Twenty-seven course participants were recruited (18 females: 9 males). Eighteen delegates (67%) had experience 100 cases. The mean perceived degree of realism was 3.85 ± 0.99, and for abdominal cavity 4.00 ± 1.25, port placement 3.52 ± 1.40, pneumoperitoneum creation 3.59 ± 1.39, camera manipulation 4.07 ± 1.09, instrument manipulation 4.44 ± 1.13, tissue dissection 4.11 ± 0.99 and intracorporal suturing and knot tying 4.22 ± 1.37. The perceived degree of improvement of understanding MAS basics was 4.65 ± 0.55, knowledge 4.15 ± 1.11, confidence and ability 4.15 ± 1.11. The overall satisfaction with the avian model was 4.64 ± 0.56. The novel avian tissue model for neonatal MAS training could be validated with success. Validation assessment demonstrates that this model is very realistic and effective, making it possible to gain laparoscopic skills especially with intracorporeal suturing and knot tying in a small space. The avian model is a proven and cost-efficient simulator for neonatal MAS training and expands the spectrum of already established simulation models for pediatric surgeons.