Dissection Skills Research Articles

Clinical practice guideline for robotic surgical system-assisted thyroid and parathyroid surgery (2024 edition)

The use of robotic operating systems is an advancement of intelligent precision, minimally invasive surgery. It has been used in the field of thyroid surgery with satisfactory results. Robotic surgery system assisted thyroid and parathyroid surgical expert consensus(2016) as played an important role in the standardization and clinical popularization of robotic surgical system-assisted thyroid and parathyroid surgery. With the deepening of clinical practice, updates in minimally invasive concept, the replacement of robotic platforms and the continuous improvement of technology, robotic thyroid and parathyroid surgery has been further developed. Notably, it has made substantial progress in expanding indications and the training of robotic surgeons and teams. Based on the 2016 Chinese expert consensus, combined with recent related articles and clinical studies, the Clinical Practice Guideline for Robotic Surgical System-Assisted Thyroid and Parathyroid Surgery (2024 edition) was formed. The surgical team training, indications, preoperative evaluation, patient position and space establishment, thyroidectomy procedures, neck lymph node dissection skills were summarized and recommended. Furthermore, reasonable suggestions on reoperation, parathyroid surgery and management of postoperative complications were also put forward, aiming to better guide clinical practice.

Novel gastric endoscopic submucosal dissection training model enhances the endoscopic submucosal dissection skills of trainees: a multicenter comparative study.

Endoscopic submucosal dissection (ESD) requires high endoscopic technical skills, and trainees should develop effective training methods. In collaboration with KOTOBUKI Medical, we developed the G-Master, which is a non-animal training model that can simulate various parts of gastric ESD. We aimed to clarify the usefulness of the G-Master for inexperienced ESD trainees. We collected data from the first 5 gastric ESD cases conducted by 15 inexperienced ESD trainees at 5 participating centers between 2018 and 2022. The participants were divided into two groups: the G-Master training and non-G-Master training groups. Outcome measurements, such as procedural speed, perforation rate, self-completion rate, and en bloc resection rate, were compared between the two groups retrospectively. A total of 75 gastric ESD cases were included in this study. The G-Master training group included 25 cases performed by 5 trainees, whereas the non-G-Master training group included 50 cases performed by 10 trainees. The median procedural speed for all cases was significantly faster in the G-Master training group than in the non-G-Master training group. Moreover, the procedural speed was linearly improved from the initial to the last cases in the lower location in the G-Master training group compared with the non-G-Master training group. In addition, although there was no significant difference, the G-Master training group showed lower rates of perforation and a lesser need to transition to expert operators than the non-G-Master training group. The G-Master could improve the ESD skills of inexperienced ESD trainees.

Receiving a donation call to dissection tables: various aspects of whole-body donation in northern union territory region medical college of India.

Body donation is the act of giving one's body to science for study, practice, and research. This selfless act contributed to the education and training of professionals in the field of medicine. Body donation programs allow medical students to learn about the different aspects of human anatomy, perfect their dissection skills, and develop a better understanding of the relationship between structure and function in the human body. The purpose of article is to improve body donation programs which meet ethical standards and best practices. This article emphasizes the significance of body donation to teaching medical institutions by discussing various aspects of body donation to medical colleges in India and the procedural steps followed, sample proformas and the obstacles faced during the whole process. The process of body donation varies among different countries pertaining to their legal frameworks and the challenges faced. A description of the problems faced in the process of body donation has been discussed with suggestions for potential solutions in this section. The sample formats of the forms filled by donors and the certificates issued by concerned organizations are also provided to clearly understand the process of body donation. The information compiled will pave the way for medical teaching institutions that have yet to start a body donation program.

Virtual reality simulators for temporal bone dissection: overcoming limitations of previous models

Temporal bone dissection is a critical skill for otolaryngology trainees: however, it is challenging to master due to the complex anatomy and limited exposure to cadaveric specimens. The aim of this review was to develop and evaluate a novel virtual reality (VR) simulator for temporal bone dissection, addressing the limitations of previous simulators reported in the literature. A comprehensive literature search was conducted in the PubMed, Embase, and Cochrane Library databases from inception to September 2022. The search was limited to studies that evaluated the effectiveness of VR simulators for temporal bone dissection. The quality of the included studies was assessed using the Cochrane Risk of Bias Tool. The results showed that VR simulators can significantly improve temporal bone dissection skills, including anatomical knowledge, instrument handling, and surgical performance. Compared to traditional training methods, VR simulation was associated with faster learning curves, better retention of skills, and greater confidence among trainees. However, some limitations of current VR models were identified, including the lack of haptic feedback, limited realism, and short duration of practice. VR simulators are a valuable adjunct to traditional methods for temporal bone dissection training. The recently developed VR simulator addressed the limitations of previous simulators and demonstrated its potential to enhance the training of clinicians in temporal bone dissection. Future directions for research include further validation of the simulator and exploration of its potential for use in clinical settings.

Performance and learning rate prediction models development in FLS and RAS surgical tasks using electroencephalogram and eye gaze data and machine learning

ObjectiveThis study explored the use of electroencephalogram (EEG) and eye gaze features, experience-related features, and machine learning to evaluate performance and learning rates in fundamentals of laparoscopic surgery (FLS) and robotic-assisted surgery (RAS).MethodsEEG and eye-tracking data were collected from 25 participants performing three FLS and 22 participants performing two RAS tasks. Generalized linear mixed models, using L1-penalized estimation, were developed to objectify performance evaluation using EEG and eye gaze features, and linear models were developed to objectify learning rate evaluation using these features and performance scores at the first attempt. Experience metrics were added to evaluate their role in learning robotic surgery. The differences in performance across experience levels were tested using analysis of variance.ResultsEEG and eye gaze features and experience-related features were important for evaluating performance in FLS and RAS tasks with reasonable results. Residents outperformed faculty in FLS peg transfer (p value = 0.04), while faculty and residents both excelled over pre-medical students in the FLS pattern cut (p value = 0.01 and p value < 0.001, respectively). Fellows outperformed pre-medical students in FLS suturing (p value = 0.01). In RAS tasks, both faculty and fellows surpassed pre-medical students (p values for the RAS pattern cut were 0.001 for faculty and 0.003 for fellows, while for RAS tissue dissection, the p value was less than 0.001 for both groups), with residents also showing superior skills in tissue dissection (p value = 0.03).ConclusionFindings could be used to develop training interventions for improving surgical skills and have implications for understanding motor learning and designing interventions to enhance learning outcomes.Graphical abstract

MP06-01 THE RELATIONSHIP BETWEEN TECHNICAL SKILL &amp; SURGICAL OUTCOMES: A NOVEL METHOD TO MEASURE SURGICAL QUALITY IN ROBOTIC PROSTATECTOMY

You have accessJournal of UrologyCME1 Apr 2023MP06-01 THE RELATIONSHIP BETWEEN TECHNICAL SKILL & SURGICAL OUTCOMES: A NOVEL METHOD TO MEASURE SURGICAL QUALITY IN ROBOTIC PROSTATECTOMY Mitchell G. Goldenberg, Runzhuo Ma, Christian Wagner, and Andrew J. Hung Mitchell G. GoldenbergMitchell G. Goldenberg More articles by this author , Runzhuo MaRunzhuo Ma More articles by this author , Christian WagnerChristian Wagner More articles by this author , and Andrew J. HungAndrew J. Hung More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003217.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Measures of intraoperative performance have supplanted surrogate quality metrics such as surgeon experience. Despite this, evidence supporting the use of surgical skill as a predictor of patient outcomes is often criticized for inadequately controlling for the patient heterogeneity between surgeons’ practices. We use a novel application of case-mix adjustment to demonstrate the robustness of the surgeon skill-to-outcome relationship in robot-assisted radical prostatectomy (RARP). METHODS: Bi-institutional, prospectively collected data was analyzed, including demographics, intraoperative video, and postoperative outcomes. The primary outcome was continence recovery (no pads) at 12-months postoperatively. Preoperative clinicopathological factors were evaluated using univariate logistic regression, and variables with a p-value <0.1 were included in the multivariate model. Surgeons were dichotomized based on observed-to-expected (O/E) ratio, comparing the actual continence rate among their patient with the predicted continence rate based on their patient’s characteristics (Figure 1). Finally, Dissection Assessment for Robotic Technique (DART) scores were provided by 3 independent raters for the nerve-spare (NS) dissection step, and Kruskal-Wallis tests were used to compare scores between surgeon cohorts. RESULTS: Fourteen surgeons contributing a total of 804 cases were included. Patient factors were significantly associated with 12-month continence, including age ≥70, BMI, and ASA. After applying the multivariate model, seven surgeons were found to have O/E ≥ 1 (i.e., ‘overperforming’). When comparing over- and underperforming surgeons, we did not see significant differences in surgical experience (p=0.38). DART scores across the two groups of surgeons were compared, showing significantly higher Tissue Handling (p=0.002) and Overall dissection skill scores (p=0.003) in the ‘overperforming’ cohort. CONCLUSIONS: Surgeon technical skill is predictive of postoperative outcomes, independent of differences in patient characteristics at a surgeon-level. These data add to the robust body of evidence supporting the use of surgical skill as a quality measure, with potential applications across education, accreditation, and patient safety initiatives. Source of Funding: Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Number R01CA273031. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e53 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mitchell G. Goldenberg More articles by this author Runzhuo Ma More articles by this author Christian Wagner More articles by this author Andrew J. Hung More articles by this author Expand All Advertisement PDF downloadLoading ...

PD30-04 SURGICAL GESTURES TO MEASURE SURGICAL DISSECTION PERFORMANCE IN APICAL DISSECTION OF ROBOT-ASSISTED RADICAL PROSTATECTOMY

You have accessJournal of UrologyCME1 Apr 2023PD30-04 SURGICAL GESTURES TO MEASURE SURGICAL DISSECTION PERFORMANCE IN APICAL DISSECTION OF ROBOT-ASSISTED RADICAL PROSTATECTOMY Maxwell X. Otiato, Runzhuo Ma, Timothy N. Chu, Elyssa Y. Wong, Christian Wagner, and Andrew J. Hung Maxwell X. OtiatoMaxwell X. Otiato More articles by this author , Runzhuo MaRunzhuo Ma More articles by this author , Timothy N. ChuTimothy N. Chu More articles by this author , Elyssa Y. WongElyssa Y. Wong More articles by this author , Christian WagnerChristian Wagner More articles by this author , and Andrew J. HungAndrew J. Hung More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003316.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Surgical performance impacts patient outcomes, yet ideal performance is challenging to objectively quantify. Previously, we established a surgical gesture classification system that deconstructs robotic tissue dissection into discrete basic surgical maneuvers. Here, we evaluate surgical gestures as a novel assessment method by correlating this metric with surgeon experience and technical skill assessment scores in the apical dissection (AD) of robotic-assisted radical prostatectomy (RARP). METHODS: RARPs from 2016-2018 across two international institutions were included. After standardized training, raters decoded AD surgical videos with surgical gestures. Surgeons were grouped into two experience levels by the median robotic caseload (range 80-5,800 cases; median 475 cases). The less experienced group performed <475 robotic cases and more experienced group performed ≥475 robotic cases. Videos were assessed by a validated assessment tool, Dissection Assessment for Robotic Technique (DART), which contains six domains. A Kruskal-Wallis test was used to compare surgical gesture proportion with DART scores from surgeons of different experience levels. Spearman’s correlation coefficients were used to assess the associations between surgical gesture usage and DART. RESULTS: In total, 78 surgical videos from 20 surgeons were included. More experienced surgeons (n=10) utilized larger proportions of cold cut (50% vs 39%, p=0.008) and smaller proportions of peel/push (12% vs 25%, p=0.02) than less experienced surgeons (n=10). Correlations between the surgical gestures and technical skills assessments ranged from -0.40 to 0.32 using the Spearman’s correlation coefficient (p<0.05, Figure 1b). Surgeons who utilized more retraction gestures had a lower retraction score, efficiency score, and total DART score (all p<0.05). Those who used more discrete gestures and spent more time per gesture had a lower efficiency score (both p<0.01). CONCLUSIONS: Surgeons of different experience levels use different surgical gestures during AD. Significant correlations were demonstrated between surgical gestures and dissection technical skills. Surgical gestures can serve as a novel method to teach and evaluate dissection skill. Source of Funding: Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Number R01CA273031. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e832 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Maxwell X. Otiato More articles by this author Runzhuo Ma More articles by this author Timothy N. Chu More articles by this author Elyssa Y. Wong More articles by this author Christian Wagner More articles by this author Andrew J. Hung More articles by this author Expand All Advertisement PDF downloadLoading ...

The effectiveness of instructional animation on dissection skills in pharmacy students: an innovation in educational method

The effectiveness of instructional animation on dissection skills in pharmacy students: an innovation in educational method

The effectiveness of Instructional Animation on dissection skills in Pharmacy Students: An innovation in educational method

The effectiveness of Instructional Animation on dissection skills in Pharmacy Students: An innovation in educational method

Collaborative, Two-Directional Live Streaming to Deliver Hands-on Dissection Experience during the COVID-19 Lockdown.

Cadaveric dissection is widely used in anatomy teaching worldwide. This method develops anatomical knowledge and practical dissection skills, as well as communication and team working. At the School of Anatomy, University of Bristol, two of our undergraduate units depend on dissection as a teaching tool.Social distancing guidelines brought about by COVID-19 brought challenges and meant it was not possible for all students to be present around a cadaver simultaneously. We adapted with secure, two-way live streaming, facilitated by ceiling-mounted cameras.Our units utilised the technology in slightly different ways. In a larger cohort, students were not able to attend the dissection room simultaneously and 2-4 students from each group attended, with the remainder (6-8 students) attending via Zoom. In the smaller cohort, all students attended, though only two students could be present around the cadaver, with Zoom used to stream the dissection to those distanced around the room. Those present narrated and ensured visibility of the dissection, whilst posing questions to those at home. The home group provided feedback, generated discussion, and conducted research.This chapter reflects on our experiences using this innovative teaching method. It was a valuable alternative to being in person. Whilst students might have spent less time in the dissection room, their dissection time equalled or was greater than pre-pandemic. Students developed digital confidence and built cohorts, and whilst we reflect on the need for effective communication and digital equity, we offer our best practice and solutions.Whilst in-person teaching has resumed in 2021-2022, investment in this technology enables us to rapidly pivot to a reduced in-person, or an entirely online delivery where required, and we are confident that our delivery will be effective in either case. There are also exciting opportunities for new forms of delivery as well as national and international collaborations.

Propeller flaps in partial ear reconstruction: a case series

BackgroundEar defect reconstruction still remains a surgical challenge today. Proper reconstruction should result in correction of the deformity with minimum morbidity with the aim of achieving the most esthetically pleasing outcome possible. Herein, we present our clinical experience with propeller flap reconstruction of external ear defects with a focus on indications and surgical technique.MethodsFourteen patients underwent surgery at our Plastic Surgery Unit between January 2015 and October 2019. After identifying perforators with a handheld Doppler ultrasound, a tailor-made flap was designed for each patient. Following tumor excision, dissection of the pedicle and of the remaining flap was performed with the aid of surgical loops. Flap in-setting and donor site closure were final steps.ResultsFlaps have survived in their entirety in almost all our patients (13/14) maintaining optimal color and elasticity and showing no complications. In one case, a superficial distal necrosis was observed and, in another patient, tumor recurrence took place.ConclusionsPropeller flaps offer great advantages when used in ear reconstruction ensuring excellent esthetic results with a one-stage technique. Nevertheless, it must be kept in mind that good dissection skills are required in order to avoid complications.Level of evidence: Level IV, Therapeutic study.

Perforator propeller flaps for lower extremity soft-tissue defect reconstruction: Shortening the learning curve

BackgroundThe perforator propeller flap is an advantageous option for soft tissue reconstruction in the lower limb as it ensures the preservation of the main artery and muscle, eliminates the need for microsurgical reconstruction as well as provides “like with like” resurfacing of the defects. Despite this, it remains a technically demanding reconstructive option for residents and surgeons with little experience in perforator dissection. We aimed to evaluate the clinical outcomes of our patients whose soft tissue defects were addressed with propeller flaps. MethodsA retrospective study of all propeller flap based reconstruction done on patients with soft tissue defects involving the distal third of the leg was undertaken from August 2018 to December 2020. Results28 patients were treated with propeller flaps for various lower extremity defects. The median defect size was 12 cm2. The posterior tibial artery (PTA) was used in eleven cases (39.3%) and the peroneal artery (PA) in seventeen of the cases (60.7%). The complication rate was 28.6% (n = 8). The complete flap necrosis rate was 10.7% (n = 3) and partial flap necrosis rate was 7.1% (n = 2), The rate of venous congestion was 7.1% (n = 2) and wound dehiscence occurred in 3.5% (n = 1). There was a significant negative correlation between the number of cases performed by a resident and the operative time. ConclusionAlthough propeller flaps are a reliable option to address lower extremity defects, they have a long learning curve and require a good amount of experience and perforator dissection skills to reduce the probability of flap failure. We are of the opinion that residents should be adequately trained in this procedure to ensure optimal outcome delivery.

The effect of simulation-based education before a cadaver dissection course.

Although the methods for medical education continue to evolve due to the development of medicines, the cadaver dissection course still plays a fundamental role. The cadaver dissection course allows students to learn to handle instruments correctly while actively exploring three-dimensional anatomy. However, dissection comes with the risk of accidental injury. In recent years, the number of classes offered for the cadaver dissection course has decreased while the amount of knowledge required in clinical medicine has increased. Simulation-based education (SBE) has been proven to be an effective educational method that enhances the development of practical skills by integrating learners' knowledge and skills. This study aimed to investigate the effect of SBE as a preparatory education course when taken prior to a medical student's enrollment in the cadaver dissection course. In the present study, an SBE assuming practical cadaver dissection course was performed in the Clinical Simulation Center. The frequency of injury rates per 1000h of cadaver dissection course was significantly less in 2017 and 2018 compared to that in 2016. Two years after the implementation of the SBE, average student self-efficacy scores and written examination scores significantly increased, whereas self-contentment scores were relatively unchanged. The results showed that the implementation of SBE decreased the incidence of injuries and improved students' overall self-efficacy scores and increased acquisition of knowledge evident on written examination score. Therefore, SBE as a preparatory education course may effectively promote the combined development of dissection skills and anatomical knowledge in the subsequent fundamental cadaver dissection course.

Robotic versus Open Pancreatoduodenectomy for Pancreatic and Periampullary Tumors (PORTAL): a study protocol for a multicenter phase III non-inferiority randomized controlled trial

BackgroundPancreatoduodenectomy is a complex and challenging procedure that requires meticulous tissue dissection and proficient suturing skills. Minimally invasive surgery with the utilization of robotic platforms has demonstrated advantages in perioperative patient outcomes in retrospective studies. The development of robotic pancreatoduodenectomy (RPD) in specific has progressed significantly, since first reported in 2003, and high-volume centers in pancreatic surgery are reporting large patient series with improved pain management and reduced length of stay. However, prospective studies to assess objectively the feasibility and safety of RPD compared to open pancreatoduodenectomy (OPD) are currently lacking.Methods/designThe PORTAL trial is a multicenter randomized controlled, patient-blinded, parallel-group, phase III non-inferiority trial performed in seven high-volume centers for pancreatic and robotic surgery in China (> 20 RPD and > 100 OPD annually in each participating center). The trial is designed to enroll and randomly assign 244 patients with an indication for elective pancreatoduodenectomy for malignant periampullary and pancreatic lesions, as well as premalignant and symptomatic benign periampullary and pancreatic disease. The primary outcome is time to functional recovery postoperatively, measured in days. Secondary outcomes include postoperative morbidity and mortality, as well as perioperative costs. A sub-cohort of 128 patients with pancreatic adenocarcinoma (PDAC) will also be compared to assess the percentage of patients who undergo postoperative adjuvant chemotherapy within 8 weeks, in each arm. Secondary outcomes in this cohort will include patterns of disease recurrence, recurrence-free survival, and overall survival.DiscussionThe PORTAL trial is designed to assess the feasibility and safety of RPD compared to OPD, in terms of functional recovery as described previously. Additionally, this trial will explore whether RPD allows increased access to postoperative adjuvant chemotherapy, in a sub-cohort of patients with PDAC.Trial registrationClinicalTrials.govNCT04400357. Registered on May 22, 2020

Awareness of dissection skills and tools session in preparing first MBBS learners for cadaveric dissection in medical school a qualitative analysis

Qualitative dissections require knowledge of dissection tool kit and dissection skills which acquired will allow dissector to take care for cadaveric donor while acquiring the experience and knowledge of a successful dissection. This promotes the researcher to equip the learner in initial phase with dissection skills and tools.The main objective of the study is to analyse the learner prior and after interventional sessions as to how effective the session would be helpful in improving the quality and participation of learners in dissection. A qualitative prospective cross-sectional study was done in 168 Learners of I MBBS by an interventional session on the topic through General lecture and demonstration. Learners were assessed prior and after the interventional session by same validated questionnaire. Perceptions of learners were also taken. The obtained data were compared and its significance was analysed by Chi-square test using Epi info 7.1 software.The pre and post-test scores showed a significant improvement of 64 percent on average with p value less than 0.001 indicating that the session was fruitful. 80% of learners also opined that the session stimulated interest in the subject and improved their dissection skills.An interventional session on “Awareness of dissection skills and tools” in the initial phase would increase the Learners performing quality dissections with ease. This would also help the learner to acquire better independent surgical skills and understanding in clinical phases of learning and therefore would recommend it in early phase of I MBBS Anatomy.

Anatomy Scholars Program for Medical Students Entering a Surgical Residency.

A near-peer teaching experience for upper-level medical students could help prepare them for surgical residency by providing specific education opportunities and exposure to the field of surgery. Five medical students were selected to be near-peer teachers (NPTs) in gross anatomy, and then they reflected on their experiences. The NPTs spent the majority of effort in a teaching role, and reported improved NTS, anatomy knowledge, and dissection skills. MS1s and faculty also reported on the value of the ASP. Further development and evaluation of the ASP may be an excellent opportunity for future surgeons.

Obliterated Posterior Cul-de-sac Laparoscopic Surgical Simulation

Obliteration of the posterior cul-de-sac is a challenging, often unexpected surgical finding. Developing the dissection skills required to manage this finding during laparoscopy is essential for optimizing treatment of many pain disorders during hysterectomy or ovarian surgery; however, exposure of trainees to cul-de-sac dissection is variable. Currently, there are no widely available simulation models for teaching and practicing this technique. Our aim is to design a low-cost and high-fidelity laparoscopic simulation model that represents key anatomical structures and emphasizes skills for laparoscopic dissection of an obliterated posterior cul-de-sac. A three-dimensional model was created and is described. Nine experts (gynecologic surgery fellows and attendings) and 17 residents completed a single 30-minute simulation session and completed several assessments to begin establishing the face validity of this model. Experts and residents rated the obliterated cul-de-sac simulation as highly realistic and useful. Residents showed a statistically significant increase in comfort with the dissection, from a median Likert score of 1 out of 5 (interquartile range 1-1) to 3 out of 5 (interquartile range 2-3) (P<.001). Experts scored better than residents on blinded video grading of model performance (P<.001). This low-cost and easily reproducible model fills a critical gap in gynecologic surgery education.

Development of a Low-Fidelity Laparoscopic Sacrocolpopexy Simulation Model and Evaluation of Curriculum.

Minimally invasive sacrocolpopexy (SCP) is a compelling surgical procedure that requires advanced laparoscopic suturing and dissection skills and knowledge of pelvic retroperitoneal anatomy. The aim of this study was to develop a low-cost laparoscopic SCP model and educational curriculum to improve dissection and suturing skills along with anatomic knowledge to avoid complications. The pelvic SCP model was developed with easily available material that was placed on the commercial pelvic bone model to construct a vagina, major vessels, ureter, peritoneum, and areolar tissue. A comprehensive curriculum encompassing didactic and technical skills components on the pelvic model was used to teach laparoscopic SCP. Participants completed precurriculum and postcurriculum multiple-choice questionnaires to evaluate the didactic component. A modified Objective Structured Assessment of Technical Skills (OSATS) tool was used to measure technical skills before and after technical skills curriculum. Among the 10 senior residents, 6 (60%) were studying at their fourth postgraduate year, and 3 (30%) were studying at their third postgraduate year. Postcurriculum test scores (14.5 vs 10.6) for assessment of cognitive knowledge were significantly improved (P < 0.001). The median postcurriculum OSATS scores (26.5; range, 18-30) were significantly improved (P = 0.005). Laparoscopic SCP OSATS scores increased from median 21 to median 26.5 after cognitive and technical curriculum, showing a 21.4% improvement. The majority (70%) of residents believed that the SCP model would be useful to enhance skills acquisition before performing the skill in the operating room. A low-fidelity laparoscopic SCP curriculum showed improvement in cognitive knowledge and technical skills.

Clinical Anatomy and Surgical Training as an Education Model for Anatomy Near‐Peer Teacher

Introduction Near-peer teacher (NPT)s have become an important element in anatomy teaching. They aid educators’ workload, facilitate information, promoting active discussion, and creating collaborative learning. The Universidad Autonoma de Nuevo Leon, has a 7-year medical school program, with Human Anatomy as a 19-week course averaging over 700 students per semester. Breaking down large anatomy groups into 5-8 student groups is possible with over 60 NPTs enrolled. The anatomy course includes interactive regional anatomy lectures, laboratory sessions (dissection, prosection, and ultrasound), and clinical and imaging case discussions. For NPTs to be effective, they are exposed to continuous education and training. NPT education teaching program The NPT training objectives are to provide knowledge and skills. Weekly 2-hour training sessions with experienced educators prepare them for the upcoming activities. NPTs are classified within the department as freshmen, sophomore, junior, or senior according to their experience (1-2, 3-4, 5-6, or ≥7 semesters as an NPT). Freshmen participate in the lectures to develop educational and teaching skills. They also increase anatomical knowledge through discussion, repetition, and teaching. They lead lectures with surveillance by educators, and are given constructive feedback. Sophomores and juniors are responsible for the clinical cases and imaging sessions. Clinical cases are reviewed with specialists (usually former NPTs) from different clinical fields, depending on the topic. Radiological studies are reviewed to compare and discuss anatomy and pathological findings. Seniors oversee the prosections and dissections with students and are responsible for teaching basic suturing skills. They are given dissection and suturing courses by specialized surgical personnel (surgeons). Clinical Anatomy and Surgical Training NPT participation is voluntary, with considerable intrinsic/extrinsic rewards. Few receive a scholarship or monetary payment for their participation. Knowledge and time are the most valuable payments provided. The following workshops are provided: Advanced Dissection Skills Advanced Suturing Skills Laparoscopic Anatomy Fundamentals of Ultrasound Ultrasound-Guided Central Venous Catheterization Fundamental Skills of Minimally Invasive Surgery Laparoscopic Dissection and Suturing Virtual Arthroscopy Diploma equivalent to 300 hours of continuous education is awarded. Sense of Belonging NPT perception surveys have reported high satisfaction and agreed the staff involved in the sessions were experts and motivated them to keep learning. NPTs have a sense of belonging in the anatomy department. When questioned if they aspired to become an anatomy professors at the UANL 76.3% agreed (67.4% as a full-time professor, 79.5% as a part-time professor, and 51.1% as a voluntarily invited professor. The percentage significantly decreased when asked regarding teaching in another course/department (56.2%) as well as teaching anatomy for another university (60.4%). Highlighting the sense of belonging.

Un nuevo enfoque de enseñanza anatómica: técnica Caldwell-Luc modificada

Introducción. Conocer la morfología ocular es crucial para la formación de estudiantes de medicina; sin embargo, el aprendizaje de la anatomía del ojo está limitado a modelos virtuales e ilustraciones que no ofrecen una impresión real de la cavidad orbitaria y su contenido. Al respecto, se ha demostrado que el uso de técnicas de disección mejora el aprendizaje morfológico de cualquier estructura anatómica.Objetivo. Modificar la técnica Caldwell-Luc con un abordaje superior simultáneo que permita acceder a todas las estructuras extrínsecas del ojo contenidas en la cavidad orbitaria y, de esta forma, facilitar su estudio in situ.Materiales y métodos. Basándose en una revisión exhaustiva de la literatura, primero se realizaron prácticas de disección con ojos porcinos para adquirir la experiencia necesaria y luego se procedió a realizar la disección por planos en un cadáver humano: se llevó a cabo el corte del hueso maxilar y el corte horizontal en la base del cráneo.Resultados. La disección de todos los músculos extrínsecos del ojo permitió observar los nervios (pares craneales) con sus ramos desde una perspectiva inferior y superior de la cavidad orbitaria.Conclusión. La aplicación satisfactoria de la técnica modificada de Caldwell-Luc descrita en el presente estudio constituye una mejor herramienta para la enseñanza y el aprendizaje de la anatomía ocular, ya que esta permite observar la mayor cantidad de estructuras anexas del ojo in situ y ofrece una oportunidad para mejorar las habilidades en disección anatómica de los estudiantes.