Dissection Stations Research Articles

Analysis of Domain Addressed and Subdivisions of Anatomy Emphasized in Spotting Stations in Anatomy Part of First Professional MBBS Examination

Introduction: Assessment of any educational program should implement purpose of the learning objectives. Learning objectives are prepared with the help of several models such as SOLO (Structure of observed learning Outcomes) taxonomy, Bloom’s Taxonomy etc. The most commonly used classification system is “Bloom’s taxonomy to develop learning objectives” which describes the domains of educational objectives and divides the domains into three categories a) cognitive domain b) psychomotor domain c) affective domain. Objectives: To observe the domains of the questions of soft part-portion of Spotting stations to fulfill the learning objectives set by the curriculum in Anatomy professional examination in the background of Bloom’s Taxonomy. The research also tries to find out the subdivisions of Anatomy preferred more and regions of Gross Anatomy more emphasized in soft part-portion of Spotting stations. Methods: This cross sectional study held in the Department of Anatomy in Armed Forces Medical College (AFMC) from August 2015 to December 2018. Data (questions of soft part-portion of Spotting stations and ‘answer key’s) are collected from seven different medical colleges affiliated under Dhaka University. A total fifty-two day’s questions with ‘answer key’s are taken for the study from the first professional examination held on May 2013 and May 2014. For the purpose of the study each question is divided into ‘Item’, ‘Part’s and ‘Segment’s. Moreover verbs of the segments are then analyzed in the form of ‘statement’, ‘list’ and ‘single name’ and Anatomy is subdivided into Gross Anatomy, Histology and Developmental Anatomy. Result: A total 774 items, 1571 parts, 2048 segments are analyzed. The verbs used to address the levels of cognitive domain in the questions reveals that ‘identification’ is mostly (76.62%) used in supplied figure followed by radiology (52.05%) model (41.89%) viscera (38.82%) and dissection (24.95%) stations. ‘Statement’ mostly used as verb by dissection (37.28%) and minimum in supplied figure (11.6%) stations. Similarly ‘list’ is mostly used in viscera (23.14%) and ‘single name’ is mostly used verb in dissection stations. Maximum (89.2%, 92.47%, 90.54% and 81.82%) questions are asked from Gross Anatomy subdivision in viscera, radiology, model and in supplied figure stations respectively. In case of viscera stations about one third (34.62%) and one fourth (25.62%) questions are from the thorax and abdomen proper respectively and around 15% questions cover pelvis, (10.54%) head neck, (12.34%) and brain (16.88%) respectively. Nearly half (46%) of the figure station use supplied figures as a ‘tool’. Maximum (39%) figures are used from brain where supplied figures are used as a ‘tool’ and no figure used from lower limb. When instructed to ‘draw and label’, 50% are from region of brain and less than 20% from other regions. Conclusion: From the findings it can be easily perceived that though Spotting examination is part of practical examination but in our country but it mainly involves in assessing factual knowledge of Anatomy which can hardly meet the demand of the objectives set by the curriculum. JAFMC Bangladesh. Vol 19, No 1 (June) 2023: 59-65

Developing a non-cadaveric brain tumour surgery lab in resource-constrained settings.

To develop the country's first brain tumour surgery lab in resource-constrained settings, for training young neurosurgeons and residents. A workshop was developed using mixed-fidelity models for assessing and training a participant's psychomotor skills, hand-eye coordination, and teaching the principles of brain tumour surgery. Affordable noncadaveric models were used to compare and contrast the benefit of each teaching model. Within the existing space for wet labs at our institution, 8 different dissection stations were set up with adequate space for 2 people to work at a time. Each station was equipped with an operating room-Caliber microscope, a lighting system and a camera linked to a screen and high-powered electric drills and basic surgical equipment. Our team was able to develop and use 3D-printed skull models and animal brain models for training in complex approaches and craniotomy. Surgical simulation training, in a cost-effective manner, provides the benefit of training residents and students in neurosurgical techniques in a safe, controlled environment leading to improvement in skills and technique.

Learner Preference on the Teaching Modalities in Musculoskeletal Anatomy in the New Normal: A Cross-sectional Study Comparing Dissection Educational Videos and Self-directed Manual to Proctor-assisted Cadaver Dissection

Background. The COVID-19 pandemic affected all medical education because of the suspension of face-to-face learning and stringent protocols. Various methods of teaching were introduced to augment anatomical learning.Objective. As we enter the transition period and loosening of protocols for face-to-face learning, we want to know if these modes of teaching are still preferred and suitable or the traditional proctor-assisted dissection is preferable among first year medical students.Methods. This descriptive cross-sectional study recruited first-year medical students currently enrolled at the University of the Philippines College of Medicine during the Department of Anatomy Learning Enhancement Program (LEAP) from June 13-17, 2022. One station caters to musculoskeletal anatomy. The musculoskeletal station is further divided into four mini stations: a prosected lower extremity cadaver with labels of must know anatomic structures for the proctor-assisted cadaver dissection; a prosected lower extremity with a self-directed manual for the students to follow; a large screen television for the dissection educational videos focusing on the shoulder girdle; and lastly, skeletons for osteology. Thirty minutes were allotted per sub-station in the musculoskeletal station of LEAP. After completing the station, the students were provided with evaluation forms and a 30-item survey to determine the preferred teaching modality in musculoskeletal anatomy.Results. A total of 145 students out of the 178 students participated and answered the survey and evaluation form. Ninety-nine percent of the students rated the proctor-assisted dissection station great and excellent (13% and 86% respectively) and that 86% of the students preferred proctor-assisted dissection among the teaching modalities. Additionally, 89% (46% strongly disagreed and 43% disagreed) and 83% (55% strongly disagreed and 28% disagreed) of the students disagreed that they prefer self-directed module or dissection educational videos over traditional dissection, respectively. Mostof the students also agreed that the inability of face-toface dissection will affect their medical education (35% agreed and 64% strongly agreed) and majority of them thinks that cadaver dissection is vital in their medical education and towards becoming a doctor (14% agreed, 86% strongly agreed). 
 Conclusion. With the plethora of teaching modalities introduced during the pandemic, medical students still preferred the traditional proctor-assisted dissection. However, they see the value of the other teachingmodalities as an added armamentarium in enhancing anatomical knowledge.

Inside-Out Surgical Anatomy of Superior Laryngeal Artery Endoscopic Dissection and Proposal for Nomenclature of Branches.

To describe the inside out surgical anatomy of the superior laryngeal artery and to resolve the ambiguities in the nomenclature of its main branches. Endoscopic dissection of the superior laryngeal artery in the paraglottic space of larynges of fresh frozen cadavers and a review of the literature. A center for anatomy encompassing facilities for latex injection into the cervical arteries of human donor bodies and a laryngeal dissection station equipped with a video-guided endoscope and a 3-dimensional camera. Video-guided endoscopic dissection of 12 hemilarynges in fresh frozen cadavers whose cervical arteries were injected with red latex. Description of the inside-out surgical anatomy of the superior laryngeal artery and its main branches. Review of the previous reports describing the anatomy of the superior laryngeal artery. From inside the larynx, the artery was exposed upon its entry through the thyrohyoid membrane or through the foramen thyroideum. It was traced ventrocaudally in the paraglottic space exposing its branches to the epiglottis, the arytenoid, and the laryngeal muscles and mucosa. Its terminal branch was followed until it left the larynx through the cricothyroid membrane. Branches of the artery, previously described under different names, appeared to supply the same anatomical domains. Mastering the inside out anatomy of the superior laryngeal artery is mandatory to control any intraoperative or postoperative hemorrhage during transoral laryngeal microsurgery or during transoral robotic surgery. Naming the artery's main branches according to their domain of supply would resolve the ambiguities resulting from various nomenclatures.

Study of the short-term quality of life of patients with esophageal cancer after inflatable videoassisted mediastinoscopic transhiatal esophagectomy.

To compare the short-term outcomes and postoperative quality of life in patients with esophageal cancer between inflatable videoasisted mediastinoscopic transhiatal esophagectomy (IVMTE) and minimally invasive Mckeown esophagectomy (MIME), and to evaluate the value of IVMTE in the surgical treatment of esophageal cancer. A prospective, nonrandomized study was adopted. A total of 60 esophageal cancer patients after IVMTE and MIME December 2019 to January 2022 were included. Among them, 30 patients underwent IVMTE and 30 patients underwent MIME. Shortterm outcomes (including the operation time, intraoperative blood loss, postoperative drainage 3 days, total postoperative tube time, postoperative hospital stay, number and number of thoracic lymph node dissection stations, postoperative complications and so on), postoperative quality of life, [including Quality of Life Core Questionnaire (QLQ-C30) and the esophageal site-specific module (QLQ-OES18)] were compared between the 2 groups. The operation time, intraoperative blood loss, postoperative drainage volume and total postoperative intubation time in IVMTE group were significantly lower than those in MIME group (P < 0.05). A total of 22 patients had postoperative complications, including 7 patients in IVMTE group (23.3%) and 15 patients in MIME group (50.0%). There was significant difference between the two groups (P = 0.032). The physical function, role function, cognitive function, emotional function and social function and the overall health status in the IVMTE group were higher than those in the MIME group at all time points after operation, while the areas of fatigue, nausea, vomiting and pain symptoms in the MIME group were lower than those in the MIME group at all time points after operation. IVMTE is a feasible and safe alternative to MIME. Therefore, when the case is appropriate, IVMTE should be given priority, which is conducive to postoperative recovery and improve the quality of life of patients after operation.

Clinical analysis of inflatable video-assisted mediastinoscopic transhiatal esophagectomy combined with laparoscopy

Objective: To examine the safety and effectiveness of inflatable video-assisted mediastinoscopic transhiatal esophagectomy (IVMTE). Methods: Totally 269 patients admitted to the Anhui Provincial Hospital of Anhui Medical University who underwent IVMTE (IVMTE group, n=47) or thoracoscopy combined with minimally invasive Mckeown esophageal cancer resection (MIME group, n=222) from September 2017 to December 2021 were analyzed retrospectively. There were 31 males and 16 females in IVMTE group, aged (68.6±7.5) years (range: 54 to 87 years). There were 159 males and 63 females in MIME group, aged (66.8±8.8) years (range: 42 to 93 years). A 1∶1 match was performed on both groups by propensity score matching, with 38 cases in each group. The intraoperative conditions and postoperative complication rates of the two groups were compared by t test, Wilcoxon rank, χ2 test, or Fisher exact probability method. Results: Patients in IVMTE group had less intraoperative bleeding ((96.0±39.2) ml vs. (123.8±49.3) ml, t=-2.627, P=0.011), shorter operation time ((239.1±47.3) minutes vs. (264.2±57.2) minutes, t=-2.086, P=0.040), and less drainage 3 days after surgery (85(89) ml vs. 675(573) ml, Z=-7.575, P<0.01) compared with that of MIME group. There were no statistically significant differences between the two groups in terms of drainage tube-belt time, postoperative hospital stay, and lymph node dissection stations and numbers (all P>0.05). The incidence of Clavien-Dindo grade 1 to 2 pulmonary infection (7.9%(3/38) vs. 31.6%(12/38), χ²=6.728, P=0.009), total complications (21.1%(8/38) vs. 47.4%(18/38), χ²=5.846, P=0.016) and total lung complications (13.2%(5/38) vs. 42.1%(16/38), χ²=7.962, P=0.005) in the IVMTE group were significantly lower. Conclusion: Inflatable video-assisted mediastinoscopic transhiatal esophagectomy combined with laparoscopic esophagectomy is safe and feasible, which can reach the same range of oncology as thoracoscopic surgery.

Clinical value of regional lymph node sorting in gastric cancer.

Increasing evidence have shown that regional lymph node metastasis is a critical prognostic factor in gastric cancer (GC). In addition, lymph node dissection is a key factor in determining the appropriate treatment for GC. However, the association between the number of positive lymph nodes and area of lymph node metastasis in GC remains unclear. To investigate the clinical value of regional lymph node sorting after radical gastrectomy for GC. This study included 661 patients with GC who underwent radical gastrectomy at Tianjin Medical University General Hospital between January 2012 and June 2020. The patients were divided into regional sorting and non-sorting groups. Clinicopathological data were collected and retrospectively reviewed to determine the differences in the total number of lymph nodes and number of positive lymph nodes between the groups. Independent sample t-tests were used for intergroup comparisons. Continuous variables that did not conform to a normal distribution were expressed as median (interquartile range), and the Mann-Whitney U test was used for inter-group comparisons. There were no significant differences between the groups in terms of the surgical method, tumor site, immersion depth, and degree of differentiation. The total number of lymph nodes was significantly higher in the regional sorting group (n = 324) than in the non-sorting group (n = 337) (32.5 vs 21.2, P < 0.001). There was no significant difference in the number of positive lymph nodes between the two groups. A total of 212 patients with GC had lymph node metastasis in the lymph node regional sorting group, including 89 (41.98%) cases in the first dissection station and 123 (58.02 %) cases in the second dissection station. Binary and multivariate logistic regression results showed that the number of positive lymph nodes (P < 0.001) was an independent risk factor for lymph node metastases at the second dissection station. Regional sorting of lymph nodes after radical gastrectomy may increase the number of detected lymph nodes, thereby improving the reliability and accuracy of lymph node staging in clinical practice.

Effect and feasibility of uniportal thoracoscopic surgery in the treatment of early-stage lung cancer in a primary hospital.

BackgroundThoracoscopic radical lobectomy is a routine procedure for radical surgery of lung cancer. Meanwhile, thoracoscopic surgery has been gradually transformed from assisted small incision and multiport thoracoscopic radical surgery to uniportal thoracoscopic surgery for treatment of early-stage lung cancers. However, there are still controversies regarding the efficacy and feasibility of 2 surgical methods. The purpose of this study is to investigate the effect and feasibility of uniportal thoracoscopic surgery for treatment of early-stage lung cancer in a primary hospital.MethodsClinical data of 142 patients with early-stage lung cancer were retrospectively chosen in the period from September 2019 to March 2021 in our hospital and divided into 2 groups: a control group (66 patients) with 3-port thoracoscopic radical surgery and an experimental group (76 patients) with uniportal thoracoscopic radical surgery. The baseline clinical data, perioperative clinical data, and lymph node dissection of 2 groups were compared.ResultsThere was no significant difference in baseline general clinical data between 2 groups (P>0.05), and no significant difference in the incidence of postoperative complications, conversion rate, or operation time between 2 groups (P>0.05). The intraoperative blood loss volume, postoperative chest drainage volume, postoperative hospitalization time, and postoperative catheter time of experimental group were significantly lower than those of control group (P<0.05). There was no significant difference in the total number of lymph node dissection stations and lymph node dissections, the number of N2 lymph node dissection stations, or N2 lymph node dissections between 2 groups (P>0.05). There was also no significant difference in the number of left and right lymph node dissection stations between 2 groups (P>0.05).ConclusionsCompared with 3-port thoracoscopic radical surgery, uniportal thoracoscopic radical surgery in the treatment of patients with early-stage lung cancer provides the same effect of lymph node dissection and has advantages in reducing surgical trauma and accelerating postoperative rehabilitation, popularizing for use in primary hospitals.

Effectiveness and postoperative pain level of single-port versus two-port thoracoscopic lobectomy for lung cancer: a retrospective cohort study

ObjectivesSingle-port thoracoscopic lobectomy is a new therapeutic technique for patients with lung cancer; however, insufficient data are available regarding its clinical outcomes. We therefore compared the clinical outcomes of single-port and two-port thoracoscopic lobectomies for lung cancer.MethodsWe retrospectively analyzed and compared the data of 204 and 368 patients with lung cancer who underwent single-port or two-port thoracoscopic lobectomy, respectively, between October 2014 and October 2017 at our institution. Patients in both groups underwent 1:1 propensity score matching, and 400 patients (200 patients in each group) were included. Perioperative clinical indicators were analyzed, including operation time, lymph node dissection stations and numbers, incidence of postoperative complications, and pain scores at 24 h, 72 h, and 1 week after surgery.ResultsNo perioperative deaths occurred in either group. The operation time, intraoperative blood loss, chest drainage duration, duration of postoperative hospital stay, lymph node dissection station and number, rate of conversion to open surgery, number of ruptured intraoperative pulmonary vessel, and incidence of postoperative complications were not significantly different between the groups (all P > 0.05). However, analysis of the 24-h (P = 0.005), 72-h (P = 0.011), and 1-week (P = 0.034) visual analog scale score after surgery revealed that the postoperative pain levels were significantly lower in the single-port than in the two-port group.ConclusionsSingle-port and two-port thoracoscopic lobectomies had similar perioperative outcomes, although the postoperative pain was lower after single-port than two-port thoracoscopic lobectomy. Hence, we concluded that single-port thoracoscopic lobectomy is an effective, minimally invasive, and promising surgical procedure.

Simulation of Pediatric Endoscopic Cricoid Reduction and Expansion

Endoscopic cricoid expansion and reduction are newer approaches to the management of pediatric bilateral vocal fold immobility and postlaryngotracheal reconstruction glottic insufficiency, respectively. These procedures offer a less invasive, endoscopic alternative to procedures that typically required open management with a more prolonged recovery. These technically demanding procedures are currently performed only in select centers, and there is no currently described training model for practicing them. We present a modification to a laryngeal dissection station that allows for simulation of endoscopic cricoid reduction and expansion with excised larynges. The model allows trainees to practice endoscopic posterior cricoid exposure, incision of the cricoid cartilage, placement of a simulated costal cartilage graft for expansion, and endoscopic suturing for reduction. Development of simulators for procedures that are infrequently performed have the potential to help trainees reach surgical competency faster and more safely.

Efficacy comparison of single utility port and multiple utility ports thoracoscopic lobectomy for peripheral lung cancer

Objective To compare the clinical efficacy of single utility port and multiple utility ports thoracoscopic lobectomy in the treatment of peripheral lung cancer, and to study the operation skills, relative merit and feasibility of the single utility port thoracoscopic lobectomy. Methods The clinical data was analyzed retrospectively for 223 cases with stageⅠ orⅡ of peripheral lung cancer who underwent thoracoscopic lobectomy from July 2011 to November 2014 in Shanxi Provincial Cancer Hospital. Among 223 cases, 78 cases received single utility port thoracoscopic lobectomy (single utility port group), 145 cases received 2 or 3 utility ports thoracoscopic lobectomy (multiple utility ports group). The clinical outcomes involved time of operation, intraoperative blood loss,chest drainage, postoperative hospital stay, stations of lymph node dissection, numbers of lymph node dissection, rate of turn to open, postoperative complications, 2-year survival rate and disease free survival rate. Results No perioperative death occurred in both groups. There was no statistical difference between single utility port group and multiple utility ports group in operation time [(157.4±13.6) min vs. (151.3±23.2) min], intraoperative blood loss [(180.77±59.97) ml vs. (171.31±77.51) ml],chest drainage [(370.26± 146.09) ml vs. (351.17±159.07) ml], lymph node dissection stations (4.29±0.65 vs. 4.21±0.73), lymph node dissection number (11.50±2.30 vs. 11.04±2.29), rate of turn to open [(5.13% (4/78) vs. 4.83% (7/145)], incidence of postoperative complications [17.95% (14/78) vs. 15.86% (23/145)], postoperative hospital stay [(8.74±0.51) d vs. (9.48±0.63) d], 2-year survival rate [96.15% (75/78) vs. 93.79% (136/145)] and 2-year disease free survival rate [80.77% (63/78) vs. 82.07% (119/145)] (all P > 0.05). Conclusions The single utility port thoracoscopic lobectomy could achieve the same clinical results as the multiple utility ports. The single utility port thoracoscopic lobectomy is a safe, effective and feasible surgical procedure. Key words: Lung neoplasms; Thoracic surgical procedures; Thoracoscope; Single utility port

Simulation of KTP Laser-Based Zenker Diverticulotomy with a Porcine Model and Laryngeal Dissection Station.

Zenker’s diverticulum is a rare cause of progressive dysphagia that is treated surgically. Potassium titanyl phosphate (KTP) laser–based diverticulotomy is one effective treatment. Developing a simulation model is helpful for rare conditions. Pigs have a natural hypopharyngeal pouch similar to a diverticulum. We present a model for performing rigid endoscopic KTP laser diverticulotomy in a porcine model with a laryngeal dissection station. Eleven pigs were examined to confirm presence of the hypopharyngeal pouch. A specimen was mounted on the modified laryngeal dissection station, and a KTP laser–based diverticulotomy was performed. Novel aspects include use of the laryngeal dissection station and application of the model for simulating rigid endoscopic KTP laser diverticulotomy. This model allows trainees to practice equipment setup, positioning of the laryngoscope to isolate the cricopharyngeal bar, tissue handling, laser safety techniques, and use of the KTP laser through the laryngoscope under microscopic visualization.

Three-dimensional printing of a low-cost, high-fidelity laryngeal dissection station.

Microlaryngeal phonosurgery requires a significant amount of operative precision to obtain desired voice outcomes.1,2 Residents have traditionally developed these skills via intraoperative experience; however, with growing duty-hour restrictions and relatively limited case volume, it has become more difficult to achieve mastery of these super-specialized procedures through operative experience alone. In fact, the majority of otolaryngology–head and neck surgery residents believe their training in phonomicrosurgery would be enhanced by laboratory-based simulation sessions.3 Accordingly, several authors have described laryngeal dissection stations aimed at facilitating such simulations.2,4,5 All these have a role in increasing competence among trainees and in allowing for the instruction of phonosurgical technique. Within the realm of surgical simulation, there is tension between high-fidelity and low-fidelity models. High-fidelity models more closely mimic clinical phonosurgery in equipment and task, but they often have a large cost associated with their manufacture and are not always readily available, especially if several stations are needed (personal conversation with Dr. Dailey and Dr. Jiang regarding availability of their teaching station for purchase by the senior author, LMA).5,6 To solve these issues, lower cost models have been described utilizing commonly available materials; however, as described, this lower cost model requires use of a clinical laryngoscope, something not feasible in institutions that do not allow instrumentation to be shared between patient-care and teaching lab environments.7 Also, this low-cost model offers lower fidelity in the modeling of microlaryngeal surgery: rubber bands, bacitracin, and plastic wrap are used to simulate layers of the true vocal fold given that the system is not designed to hold an animal larynx. A laryngeal dissection station that was simultaneously high fidelity and low cost would solve this tension and improve the teaching of phonosurgery in a simulation setting. Ideally, this station would closely mimic the conditions of operative microlaryngoscopy in terms of dimensions, positioning, and stability of the laryngoscope; would allow for the use of animal larynges that make possible high-fidelity modeling of phonosurgery; would not require the use of a clinical laryngoscope from the operating room; and would be readily available for those in any programs who wished to use it.6,8 Here, we describe a laryngeal dissection station constructed with a 3-dimensional (3D) printed laryngoscope that fulfills these criteria.

Dissection station 2 and 4 on the right hemithorax

Dissection station 2 and 4 on the right hemithorax

From biportal to uniportal video-assisted thoracoscopic anatomical lung resection: A single-institute experience.

Our study sought to review our experience from biportal to uniportal video-assisted thoracoscopic surgery (VATS) major lung resection. Lessons we learned from the evolution regarding technical aspects were also discussed.We retrospectively reviewed patients who underwent VATS lobectomy or segmentectomies in Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan, during January 2012 and December 2014. Patient clinical profiles, surgical indications and procedures, postoperative course, and oncological parameters were analyzed and compared between the biportal and uniportal groups.A total of 121 patients were enrolled in this study with median follow-up of 19.5 ± 11.6 months for all patients and 22.5 ± 11.5 months for primary lung cancer patients. Operation time (146.1 ± 31.9–158.7 ± 40.5 minutes; P = 0.077), chest drainage time (3.8 ± 3.3–4.4 ± 2.4 days; P = 0.309), conversion to thoracotomy rate (2.2%–2.6%; P = 0.889), and complication rate (15.6%–19.7%; P = 0.564) were equal between the groups, whereas blood loss (96.7 ± 193.2–263.6 ± 367; P = 0.006) was lower in the uniportal group. For lung cancer cases, there were no statistical differences in the histology, cancer staging, mediastinal lymph node dissection stations, numbers of dissected N1, N2, and overall lymph nodes between uniportal and biportal groups.Our preliminary data showed that uniportal VATS anatomical lung resection is as feasible, equally safe, and of comparative oncological clearance efficacy to biportal VATS.

Novel Dissection Station for Endolaryngeal Microsurgery and Laser Surgery: Development and Dissection Course Experience.

Objective We aimed to develop and validate an ex vivo dissection station for endolaryngeal surgery suitable for different kinds of laryngeal specimen and any type of operating technique (CO2 laser, cold instruments by endoscopic or microscopic techniques). Study Design Experimental construction and validation of a highly specialized dissection station. Setting Laboratory and international dissection course. Methods We designed a lightweight dissection station made of polycarbonate resin approved for use with a CO2 laser. The cylindrical box hosts an articulated laryngeal support. The laryngoscope is positioned on an articulated arm, which is fixed on the construction's footplate. Validation of the larynx box was performed during an international dissection course on laryngeal surgery held in January 2016. Results We assessed the suitability of our novel dissection station among specialized laryngologists with a mean experience of 14 years. Feedback from the participants was very positive, with a mean general impression of 9.5 (out of 10 points) and a recommendation score of 9.6 for further use. Its utility in transforming the taught surgical steps into daily practice has been highly recognized, with a score of 9.5. Conclusion The lightweight and transparent larynx box is suitable for any kind of laryngeal specimen, and any surgical intervention can be taught at reasonable cost. It is safe and suitable for use with CO2 lasers. Validation among experienced surgeons revealed its suitability in the teaching of endolaryngeal microsurgery and laser surgery.

An affordable model for endolaryngeal phonomicrosurgery: Chicken wings and foam pipe insulation tube

INTRODUCTION Surgical models and phantoms are widely used in medical training, especially in ultrasound-guided interventions or surgical training such as laparoscopic skills. Time spent using phantoms leads to improvements in confidence and success rate. There are numerous articles describing different models or simulators for learning and improvement of ear, nose, and throat surgical skills. These include models for endoscopic sinus and skull base surgery, myringotomy and insertion of tympanostomy tubes, ear surgery simulators, and even a trainer for ligating the lower tonsillar pole. Several models for laryngeal microsurgery have been presented. These include laryngeal dissection stations using cadaveric larynges, animal larynges, or synthetic larynges. A summary of models designed for endolaryngeal microsurgical training is presented in Table I. In this article we present an inexpensive, easy-touse, and feasible laryngeal model based on chicken wings and polyethylene foam-pipe insulation tube.

A dissecting competition for medical students

After repeated requests from medical students for more cadaver dissection opportunities, a voluntary dissecting "competition" was initiated for the third year medical students in 2006. This has been held annually on five occasions since, offering up to 30 dissection stations and accommodating an average of 53 students (range 40-66) per year, representing about 20-25% of the total class. Material is standardized to distal upper or lower limb specimens, each of which is dissected by one or two students during a single weekend day. Participants are required to complete their dissection in about six hours and present an appropriately labeled display together with a 300 word abstract, emphasizing clinical relevance. Dissections are judged on presentation, accuracy of identification and labeling, and relevance to the clinical abstract, taking into account the technical difficulty of the particular dissection. Judging from successive annual uptake of places and informal feedback, this is not only a popular event allowing students to focus creatively on producing a clinically relevant dissection in a relaxed learning environment but also of educational value. An unexpected outcome has been the production of many specimens suitable as prosections for future classes. A dissecting competition may be a useful method of stimulating learning for medical students interested in undertaking further dissection but it requires appropriate staff commitment and a supply of suitable cadaver specimens.

A Laryngeal Dissection Station: Educational Paradigms in Phonosurgery

A Laryngeal Dissection Station: Educational Paradigms in Phonosurgery

A laryngeal dissection station: educational paradigms in phonosurgery.

To introduce a new tool for phonosurgical training and education. A multitude of innovations in complex laryngeal surgery has catalyzed new educational initiatives. Establishing dexterity in phonomicrosurgery is often difficult to achieve while working on patients because of the narrow margin for success. Furthermore, laryngoplastic phonosurgery and open partial laryngectomy require sophisticated knowledge of precise anatomic relationships, which can be difficult to express in images. Finally, many teaching programs do not have a high volume of these procedures, and there is a significant need to transmit this information in continuing education courses. Prototype design. A laryngeal dissection station (LDS) was designed to facilitate the acquisition of high-level procedural skill sets for both transoral and transcervical techniques. This LDS can be used in existing temporal-bone laboratories by using cadaveric larynges. A rectangular frame supports two adjustable holders, one for the larynx and one for the examining speculum of a laryngoscope. Procedures are performed with the larynx fixed in space by a novel fixator. Variation in position and orientation of the components affords simulation of both microlaryngoscopy and open surgery. The dissection station can accommodate virtually any laryngoscope, regardless of size or shape. This training apparatus should facilitate laryngeal surgical instruction in residency training and continuing medical education. This device and others like it can help establish clinical competency in laryngology, should this become necessary in future educational models of residency training and recertification.