1 - Cirurgia Pediátrica, Área da Saúde da Criança e da Mulher, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
2 - Serviço de Cirurgia Pediátrica, Hospital Universitario de Vall d’Hebron, Barcelona, Espanha.
- Publicação – Journal of Surgical Education, J Surg Educ. 2018 Nov;75(6):1658-1663. doi: 10.1016/j.jsurg.2018.04.005. Epub 2018 Apr 20.
Resumo:
Objective: we aimed to develop and validate a low cost, do-it-yourself model for neonatal thoracoscopic congenital diaphragmatic hernia (CDH).
Design: volunteers with varying skills in neonatal minimally invasive surgery tested and evaluated the model simulating a neonatal thoracoscopic CDH repair. The model was built from ordinary materials purchased in a dime store: a small food container, a neoprene band simulating a diaphragm, an inflated balloon simulating a spleen, a tissue chord simulating intestine and a body wash sponge simulating a collapsed lung. The evaluation comprised 3 sets of 5-point grading scale concerning appearance, necessary maneuvers and ability to generate skills. Bowel reduction and suture efficacy was verified for each test.
Setting: minimally invasive surgery simulation room at Pediatric Surgery Department of Hospital Universitario de Vall d’Hebron, Barcelona, Spain.
Participants: volunteer residents and specialists of Pediatric Surgery.
Results: Bowel reduction was possible in every test, with 1 spleen rupture, 1 bowel entrapment and 2 inappropriate sutures due to tension. Most volunteers considered the general endoscopic vision (63.2%), external and internal dimensions (both 89.5%) to be highly similar; bowel reduction (68.4%) and diaphragm’s manipulation and suture (57.9%) to be highly or very highly similar. Regarding its ability to generate skills, most considered it to be very or extremely useful concerning: camera handling (52.6%), working in small spaces and suture (both 100%) and tissue handling (63.2%). The least liked features were the colors and the diaphragm’s tension. The size, portability and the reproducibility were the most liked features.
Conclusions: we consider this low cost and easily reproducible model to be realistic enough for CDH repair training, having the potential to be adapted for other simulations.
Palavras Chave: surgical education, surgical simulation, congenital diaphragmatic hernia, neonatal surgery, pediatric thoracic surgery, resident education