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Design and validation of a simulation-based training module for ileo-transverse intracorporeal anastomosis
Indexado
WoS WOS:001408846600001
Scopus SCOPUS_ID:85217154021
DOI 10.1007/S00464-024-11516-0
Año 2025
Tipo artículo de investigación

Citas Totales

Autores Afiliación Chile

Instituciones Chile

% Participación
Internacional

Autores
Afiliación Extranjera

Instituciones
Extranjeras


Abstract



BackgroundThe benefits of the totally laparoscopic right hemicolectomy have been established, but its adoption has been limited by the challenges of intracorporeal suturing. While simulation is effective for training advanced surgical skills, no dedicated simulation-based course exists for intracorporeal ileo-transverse anastomosis (ICA). This study aimed to develop and validate a simulation module for training in ICA.MethodsThis study employed a proof-of-concept design for an educational tool. Key aspects of the anastomosis were identified using the team's surgical experience, surgical videos, and existing evidence. Surgeons were recruited to test and refine successive simulation models through an iterative process until a functional prototype was achieved and assessed. Subsequently, surgeons with varying experience levels were invited to perform an ICA in the model. Performance was evaluated by two blinded surgeons through video recordings, utilizing a modified Objective Structured Assessment of Technical Skills (OSATS), a Specific Rating Score (SRS), and operative time measurements. Non-parametric descriptive and analytical methods were applied, with results presented as median [IQR].ResultsAn ex vivo based model was developed. Seventeen participants evaluated the model. Eighty-three percent declared acceptable or maximum fidelity regarding the colon. Resemblance to the surgical scenario in terms of ergonomic and anatomical similarity was highlighted. All participants found the model useful to train intracorporeal suturing. Thirteen subjects performed the ICA. Experts achieved significantly higher OSATS scores (22.3 [22-22.5] vs 18 [16-19.5]; p = .013), exhibited a trend toward higher SRS, and obtained shorter operative times (21.5 vs 36 min; p = .039).ConclusionAn ex vivo simulation module for ICA was developed, demonstrating acceptable fidelity in replicating the surgical environment. The simulated scenario could successfully distinguish between levels of surgical experience, as evidenced by significant differences in OSATS scores and operative times, thereby confirming its construct validity.

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Disciplinas de Investigación



WOS
Surgery
Scopus
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SciELO
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Publicaciones WoS (Ediciones: ISSHP, ISTP, AHCI, SSCI, SCI), Scopus, SciELO Chile.

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Autores - Afiliación



Ord. Autor Género Institución - País
1 Jarry, Cristian - Pontificia Universidad Católica de Chile - Chile
Red de Salud UC CHRISTUS - Chile
2 Varas, Julian - Pontificia Universidad Católica de Chile - Chile
Red de Salud UC CHRISTUS - Chile
3 Inzunza, Martin - Pontificia Universidad Católica de Chile - Chile
Red de Salud UC CHRISTUS - Chile
4 Escalona, Gabriel - Pontificia Universidad Católica de Chile - Chile
Red de Salud UC CHRISTUS - Chile
5 Machuca, Eduardo - Pontificia Universidad Católica de Chile - Chile
Red de Salud UC CHRISTUS - Chile
6 Vela, Javier - Pontificia Universidad Católica de Chile - Chile
Red de Salud UC CHRISTUS - Chile
7 Bellolio, Felipe - Pontificia Universidad Católica de Chile - Chile
Red de Salud UC CHRISTUS - Chile
8 Larach, Jose Tomas Hombre Pontificia Universidad Católica de Chile - Chile
Red de Salud UC CHRISTUS - Chile

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Financiamiento



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Agradecimientos



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