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In vivo porcine training model for laparoscopic Roux-en-Y choledochojejunostomy.

Lee JS, Hong TH - Ann Surg Treat Res (2015)

Bottom Line: Both the operation time and CJ time showed a steady decrease with an increasing number of cases.Both pigs recovered completely and survived for two weeks, after which both animals were sacrificed.Human tissue simulation is excellent.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: The purpose of this study was to develop a porcine training model for laparoscopic choledochojejunostomy (CJ) that can act as a bridge between simulation models and actual surgery for novice surgeons. The feasibility of this model was evaluated.

Methods: Laparoscopic CJ using intracorporeal sutures was performed on ten animals by a surgical fellow with no experience in human laparoscopic CJ. A single layer of running sutures was placed in the posterior and anterior layers. Jejunojejunostomy was performed using a linear stapler, and the jejunal opening was closed using absorbable unidirectional sutures (V-Loc 180).

Results: The average operation time was 131.3 ± 36.4 minutes, and the CJ time was 57.5 ± 18.4 minutes. Both the operation time and CJ time showed a steady decrease with an increasing number of cases. The average diameter of the CBD was 6.4 ± 0.8 mm. Of a total of ten animals, eight were sacrificed after the procedure. In two animals, a survival model was evaluated. Both pigs recovered completely and survived for two weeks, after which both animals were sacrificed. None of the animals exhibited any signs of bile leakage or anastomosis site stricture.

Conclusion: The porcine training model introduced in this paper is an adequate model for practicing laparoscopic CJ. Human tissue simulation is excellent.

No MeSH data available.


Related in: MedlinePlus

Trocar placement and surgeon position during laparoscopic choledochojejunostomy (CJ). (A) Trocar placement. (B) Position of the surgeon during laparoscopic CJ.
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Figure 1: Trocar placement and surgeon position during laparoscopic choledochojejunostomy (CJ). (A) Trocar placement. (B) Position of the surgeon during laparoscopic CJ.

Mentions: Trocar placement is shown in Fig. 1A. A 10-mm trocar was placed in the umbilicus, and CO2 gas was insufflated to create pneumoperitoneum. A 12-mm trocar and three 5-mm trocars were placed.


In vivo porcine training model for laparoscopic Roux-en-Y choledochojejunostomy.

Lee JS, Hong TH - Ann Surg Treat Res (2015)

Trocar placement and surgeon position during laparoscopic choledochojejunostomy (CJ). (A) Trocar placement. (B) Position of the surgeon during laparoscopic CJ.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4443261&req=5

Figure 1: Trocar placement and surgeon position during laparoscopic choledochojejunostomy (CJ). (A) Trocar placement. (B) Position of the surgeon during laparoscopic CJ.
Mentions: Trocar placement is shown in Fig. 1A. A 10-mm trocar was placed in the umbilicus, and CO2 gas was insufflated to create pneumoperitoneum. A 12-mm trocar and three 5-mm trocars were placed.

Bottom Line: Both the operation time and CJ time showed a steady decrease with an increasing number of cases.Both pigs recovered completely and survived for two weeks, after which both animals were sacrificed.Human tissue simulation is excellent.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: The purpose of this study was to develop a porcine training model for laparoscopic choledochojejunostomy (CJ) that can act as a bridge between simulation models and actual surgery for novice surgeons. The feasibility of this model was evaluated.

Methods: Laparoscopic CJ using intracorporeal sutures was performed on ten animals by a surgical fellow with no experience in human laparoscopic CJ. A single layer of running sutures was placed in the posterior and anterior layers. Jejunojejunostomy was performed using a linear stapler, and the jejunal opening was closed using absorbable unidirectional sutures (V-Loc 180).

Results: The average operation time was 131.3 ± 36.4 minutes, and the CJ time was 57.5 ± 18.4 minutes. Both the operation time and CJ time showed a steady decrease with an increasing number of cases. The average diameter of the CBD was 6.4 ± 0.8 mm. Of a total of ten animals, eight were sacrificed after the procedure. In two animals, a survival model was evaluated. Both pigs recovered completely and survived for two weeks, after which both animals were sacrificed. None of the animals exhibited any signs of bile leakage or anastomosis site stricture.

Conclusion: The porcine training model introduced in this paper is an adequate model for practicing laparoscopic CJ. Human tissue simulation is excellent.

No MeSH data available.


Related in: MedlinePlus