Abstract
Background
Major vessel injury (MVI) is a dangerous complication associated with laparoscopic surgery that leads, if not properly handled, to blood loss, conversion to open surgery, and eventually death. In this paper, we describe the preliminary evaluation of the SimPORTAL MVI model, created with the goal of simulating an intra-corporeal injury to a large vessel.
Methods
For this study, we created MVI models for 17 residents (PGY 1–4). Each resident was asked to perform an intracorporeal knot on a penrose drain within a maximum time limit of 6 min (in accordance with European basic laparoscopic urological skills rules) and then to subsequently repair a vessel injury on the MVI model, which was perfused with synthetic blood, within a maximum blood loss of 3 L. During the vessel repair, low lights and pulse sounds were used to simulate the operating room environment. All participants filled out a survey pre- and post-task to score various aspects of the model.
Results
We successfully created a model that simulates a critical surgical event. None of the participants reported having previous experience repairing a MVI. Six participants were able to perform the intracorporeal knot, and 12 residents (70.5 %) were able to repair the MVI model under the given time and blood loss limits. Eleven participants agreed that the MVI model behaves like a real vessel, and six felt to be capable of performing the task prior to attempting it. Sixteen participants thought that the MVI model should be part of laparoscopic curriculums during residency.
Conclusions
The SimPORTAL MVI model is a feasible low-cost model that would be well appreciated as a part of laparoscopic curriculum for residents. Minor improvements, including pressure measurement in the vessel for task assessment, will be made in the future, and further studies are necessary to definitively validate this model.
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Acknowledgments
SimPORTAL thanks the European Urology Residents Education Programme (EUREP) and the Society of Laparoendoscopic Surgeons (SLS) for helping to facilitate the model reliability tests. Thank you to Jason Speich, Jonathan Chaika, and Jayme Lee for assistance in model building.
Disclosures
Drs. D. Veneziano, L. H. Poniatowski, R. M. Sweet, and T. Reihsen have no conflicts of interest or financial ties to disclose.
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Veneziano, D., Poniatowski, L.H., Reihsen, T.E. et al. Preliminary evaluation of the SimPORTAL major vessel injury (MVI) repair model. Surg Endosc 30, 1405–1412 (2016). https://doi.org/10.1007/s00464-015-4344-1
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DOI: https://doi.org/10.1007/s00464-015-4344-1