| ELITE--the ex vivo training unit for NOTES: development and validation. | |
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MedLine Citation:
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PMID: 20868301 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Skill training is an essential part of surgical education. Every physician has to get familiar with the various operation techniques and needs to handle the different instruments. However, mechanical and computer-based VR-simulators offer only one specific procedure, either laparoscopic or endoscopic. We designed the universal training system ELITE (endoscopic-laparoscopic interdisciplinary training entity) which is a new full synthetic ex vivo surgical training model for laparoscopic surgery, combined endoluminal/endocavitary procedures ("hybrid surgery") and NOTES. The aim of the current investigation was to integrate respiration and electro dissection into the model, and the evaluation of both innovations. The ELITE is a full-size replica of a human female torso including a gas-tight abdominal wall and offering various accesses to the abdomen. A complete organ package including liver, gallbladder, spleen, gastrointestinal tract, including the mesentery and omentum is available for this system. Cholecystectomy and appendectomy can be simulated realistically with this new training system. For more realistic conditions during operations breathing-induced organ motion could be integrated into this system. Two latex balloons were inserted into the system to imitate the function of the diaphragm. They are inflated and deflated according to the respiration cycle and move the artificial organs in a natural way. Physicians, including endoscopic/laparoscopic novices and experts, were asked to train different NOTES procedures on the model. Performance of their training and subjective appraisal of the model itself were evaluated. The opportunity of electrodissection of the gallbladder and appendix and simulation of breath excursion of the diaphragm could successfully be implemented into the training system. One recently published study showed that ELITE is a suitable tool to train different surgical procedures. All subjects (novices and endoscopic/laparoscopic experts) showed a significant learning curve during the assessment. Experts could be reliably differentiated from novices. The actual evaluation of the model showed that 97% of the subjects considered the ELITE as a useful simulator for NOTES. ELITE was validated to be a suitable tool to train different NOTES procedures. As a step by step training of NOTES is highly recommended, this training system offers the opportunity by degrees that animal experiments can be replaced, especially, for learning of basic techniques and thus costs can be significantly reduced. |
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Authors:
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Adam Fiolka; Sonja Gillen; Alexander Meining; Hubertus Feussner |
Publication Detail:
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Type: Journal Article; Validation Studies |
Journal Detail:
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Title: Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy Volume: 19 ISSN: 1365-2931 ISO Abbreviation: Minim Invasive Ther Allied Technol Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-09-27 Completed Date: 2011-01-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9612996 Medline TA: Minim Invasive Ther Allied Technol Country: England |
Other Details:
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Languages: eng Pagination: 281-6 Citation Subset: IM |
Affiliation:
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Research Group MITI, Klinikum rechts der Isar, Technische Universität Munich, Ismaninger Strasse 22, Munich, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Abdomen Animal Testing Alternatives Animals Appendectomy / education, methods Cholecystectomy / education, methods Clinical Competence Equipment Design Female Humans Laparoscopy / education*, methods Manikins* Natural Orifice Endoscopic Surgery / education*, methods |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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