Skip to main content
Erschienen in: Current Urology Reports 2/2011

01.04.2011

Surgical Simulation in Pediatric Urologic Education

verfasst von: Thomas Sean Lendvay

Erschienen in: Current Urology Reports | Ausgabe 2/2011

Einloggen, um Zugang zu erhalten

Abstract

The drive to achieve improved patient outcomes and patient safety has led to innovation in surgical education. The century-old teaching paradigms of “see one, do one, teach one” and training by opportunity are inappropriate in a surgical world of rapidly introduced advanced technologies. The need for improved surgical education methods is no more critical than in pediatric surgery, where the complexity of patient diseases and the physical size of the patients tend to challenge the limitations of existing surgical technology and skill. Surgical simulation offers extraordinary opportunities to teach multiple clinical scenarios in a safe, nonhuman patient environment where performance feedback is immediate and objective. Although minimally invasive surgical techniques (laparoscopic and robotic) are ideally suited for computer-assisted or virtual reality training, medical decision-making simulation for minimally invasive surgery and open surgery is in its infancy and, arguably, the most important aspect of effective surgical practice.
Literatur
1.
Zurück zum Zitat Kohn L, JM C, Donaldson M, eds. To err is human: Building a safer heath care system. Washington, DC: National Academy Press, 2000. Kohn L, JM C, Donaldson M, eds. To err is human: Building a safer heath care system. Washington, DC: National Academy Press, 2000.
2.
Zurück zum Zitat Zhan C, Miller MR. Excess length of stay, charges, and mortality attributable to medical injuries during hospitalization. JAMA 2003, 290:1868–1874.PubMedCrossRef Zhan C, Miller MR. Excess length of stay, charges, and mortality attributable to medical injuries during hospitalization. JAMA 2003, 290:1868–1874.PubMedCrossRef
3.
Zurück zum Zitat Batalden P, Leach D, Swing S, et al.: General competencies and accreditation in graduate medical education. Health Affairs 2002, 21:103–111.PubMedCrossRef Batalden P, Leach D, Swing S, et al.: General competencies and accreditation in graduate medical education. Health Affairs 2002, 21:103–111.PubMedCrossRef
4.
Zurück zum Zitat Healy GB. The college should be instrumental in adapting simulators to education. Bull Am Coll Surgeons 2002, 11:10–12. Healy GB. The college should be instrumental in adapting simulators to education. Bull Am Coll Surgeons 2002, 11:10–12.
5.
Zurück zum Zitat Liu A, Tendick F, Cleary K, et al.: A survey of surgical simulation: Applications, technology, and education. Presence 2003, 12:599–614.CrossRef Liu A, Tendick F, Cleary K, et al.: A survey of surgical simulation: Applications, technology, and education. Presence 2003, 12:599–614.CrossRef
6.
Zurück zum Zitat Passerotti CC, Passerotti AM, Dall’Oglio MF, et al.: Comparing the quality of the suture anastomosis and the learning curves associated with performing open, freehand, and robotic-assisted laparoscopic pyeloplasty in a swine animal model. Journal of the American College of Surgeons 2009, 208:576–86.PubMedCrossRef Passerotti CC, Passerotti AM, Dall’Oglio MF, et al.: Comparing the quality of the suture anastomosis and the learning curves associated with performing open, freehand, and robotic-assisted laparoscopic pyeloplasty in a swine animal model. Journal of the American College of Surgeons 2009, 208:576–86.PubMedCrossRef
7.
Zurück zum Zitat Brydges R, Farhat WA, El-Hout Y, Pediatric urology training: performance-based assessment using the fundamentals of laparoscopic surgery. Journal of Surgical Research 2010, 161:240–5.PubMedCrossRef Brydges R, Farhat WA, El-Hout Y, Pediatric urology training: performance-based assessment using the fundamentals of laparoscopic surgery. Journal of Surgical Research 2010, 161:240–5.PubMedCrossRef
8.
Zurück zum Zitat Kishore TA, Pedro RN, Monga M, et al: Assessment of validity of an OSATS for cystoscopic and ureteroscopic cognitive and psychomotor skills. Journal of Endourology 2008, 22:2707–11.PubMedCrossRef Kishore TA, Pedro RN, Monga M, et al: Assessment of validity of an OSATS for cystoscopic and ureteroscopic cognitive and psychomotor skills. Journal of Endourology 2008, 22:2707–11.PubMedCrossRef
9.
Zurück zum Zitat •• McQuiston L, Macneily A, Liu D, et al.: Computer enhanced visual learning method to train urology residents in pediatric orchiopexy provided a consistent learning experience in a multi-institutional trial. Journal of Urology 2010, 184:1748–53. This manuscript represents one of a few in the literature that have tested surgical curricula for medical decision-making training specific to pediatric urologic disease. There are many articles addressing technical skills training for MIS, but teaching the cognitive aspects of open surgery remains one of the most challenging endeavors in surgical education.PubMedCrossRef •• McQuiston L, Macneily A, Liu D, et al.: Computer enhanced visual learning method to train urology residents in pediatric orchiopexy provided a consistent learning experience in a multi-institutional trial. Journal of Urology 2010, 184:1748–53. This manuscript represents one of a few in the literature that have tested surgical curricula for medical decision-making training specific to pediatric urologic disease. There are many articles addressing technical skills training for MIS, but teaching the cognitive aspects of open surgery remains one of the most challenging endeavors in surgical education.PubMedCrossRef
10.
Zurück zum Zitat Maizels M, Yerkes EB, Macejko A, et al.: A new computer enhanced visual learning method to train urology residents in pediatric orchiopexy: a prototype for Accreditation Council for Graduate Medical Education documentation. Journal of Urology 2008, 180:1814–8.PubMedCrossRef Maizels M, Yerkes EB, Macejko A, et al.: A new computer enhanced visual learning method to train urology residents in pediatric orchiopexy: a prototype for Accreditation Council for Graduate Medical Education documentation. Journal of Urology 2008, 180:1814–8.PubMedCrossRef
11.
Zurück zum Zitat Jensen AR, Wright AS, Levy AE, et al: Acquiring basic surgical skills: is a faculty mentor really needed? American Journal of Surgery 2009, 197:82–8.PubMedCrossRef Jensen AR, Wright AS, Levy AE, et al: Acquiring basic surgical skills: is a faculty mentor really needed? American Journal of Surgery 2009, 197:82–8.PubMedCrossRef
12.
Zurück zum Zitat Jensen AR, Wright AS, McIntyre LK, et al.: Laboratory-based instruction for skin closure and bowel anastomosis for surgical residents. Archives of Surgery 2008, 143:852–8.PubMedCrossRef Jensen AR, Wright AS, McIntyre LK, et al.: Laboratory-based instruction for skin closure and bowel anastomosis for surgical residents. Archives of Surgery 2008, 143:852–8.PubMedCrossRef
13.
Zurück zum Zitat Peters JH, Fried GM, Swanstrom LL, et al. and the SAGES FLS Committee: Development and validation of a comprehensive program of education and assessment of the basic fundamentals of laparoscopic surgery. Surgery 2004, 135: 21–27.PubMedCrossRef Peters JH, Fried GM, Swanstrom LL, et al. and the SAGES FLS Committee: Development and validation of a comprehensive program of education and assessment of the basic fundamentals of laparoscopic surgery. Surgery 2004, 135: 21–27.PubMedCrossRef
14.
Zurück zum Zitat McCluney AL, Vassiliou MC, Kaneva PA, et al.: FLS simulator performance predicts intraoperative laparoscopic skill. Surgical Endoscopy 2007, 21:1991–5.PubMedCrossRef McCluney AL, Vassiliou MC, Kaneva PA, et al.: FLS simulator performance predicts intraoperative laparoscopic skill. Surgical Endoscopy 2007, 21:1991–5.PubMedCrossRef
15.
Zurück zum Zitat •• Van Nortwick SS, Lendvay TS, Jensen AR, et al.: Methodologies for establishing validity in surgical simulation studies. Surgery 2010, 147:622–30. This manuscript represents an exhaustive appraisal of existing surgical simulation curricula literature and offers a standard template for future surgical educators to draft validation studies. It highlights the realities of the limitations of the current simulation literature and presents recommendations for sound validation research.PubMedCrossRef •• Van Nortwick SS, Lendvay TS, Jensen AR, et al.: Methodologies for establishing validity in surgical simulation studies. Surgery 2010, 147:622–30. This manuscript represents an exhaustive appraisal of existing surgical simulation curricula literature and offers a standard template for future surgical educators to draft validation studies. It highlights the realities of the limitations of the current simulation literature and presents recommendations for sound validation research.PubMedCrossRef
16.
Zurück zum Zitat Vemulakonda VM, Cowan CA, Lendvay TS, et al: Surgical management of congenital ureteropelvic junction obstruction: a Pediatric Health Information System database study. Journal of Urology 2008, 180:1689–92.PubMedCrossRef Vemulakonda VM, Cowan CA, Lendvay TS, et al: Surgical management of congenital ureteropelvic junction obstruction: a Pediatric Health Information System database study. Journal of Urology 2008, 180:1689–92.PubMedCrossRef
17.
Zurück zum Zitat Lendvay TS, Casale P, Sweet R, et al.: VR robotic surgery: randomized blinded study of the dV-Trainer robotic simulator. Studies in Health Technology & Informatics 2008, 132:242–4. Lendvay TS, Casale P, Sweet R, et al.: VR robotic surgery: randomized blinded study of the dV-Trainer robotic simulator. Studies in Health Technology & Informatics 2008, 132:242–4.
18.
Zurück zum Zitat Kenney PA, Wszolek MF, Gould JJ, et al.: Face, content, and construct validity of dV-trainer, a novel virtual reality simulator for robotic surgery. Urology 2009, 73:1288–92.PubMedCrossRef Kenney PA, Wszolek MF, Gould JJ, et al.: Face, content, and construct validity of dV-trainer, a novel virtual reality simulator for robotic surgery. Urology 2009, 73:1288–92.PubMedCrossRef
19.
Zurück zum Zitat Lerner MA, Ayalew M, Peine WJ, et al.: Does training on a virtual reality robotic simulator improve performance on the da Vinci surgical system? Journal of Endourology 2010, 24:467–72.PubMedCrossRef Lerner MA, Ayalew M, Peine WJ, et al.: Does training on a virtual reality robotic simulator improve performance on the da Vinci surgical system? Journal of Endourology 2010, 24:467–72.PubMedCrossRef
20.
Zurück zum Zitat Seixas-Mikelus SA, Kesavadas T, Srimathveeravalli G, et al.: Face validation of a novel robotic surgical simulator. Urology 2010, 76:357–60.PubMedCrossRef Seixas-Mikelus SA, Kesavadas T, Srimathveeravalli G, et al.: Face validation of a novel robotic surgical simulator. Urology 2010, 76:357–60.PubMedCrossRef
21.
Zurück zum Zitat Haynes AB, Weiser TG, Berry WR, et al.: A surgical safety checklist to reduce morbidity and mortality in a global population. NEJM 2009, 360:491–499.PubMedCrossRef Haynes AB, Weiser TG, Berry WR, et al.: A surgical safety checklist to reduce morbidity and mortality in a global population. NEJM 2009, 360:491–499.PubMedCrossRef
22.
Zurück zum Zitat Do AT, Cabbad M, Kerr A, et al.: A warm-up laparoscopic exercise improves the subsequent laparoscopic performance of OB-GYN residents: A low-cost laparoscopic trainer. Journal of Laparoendoscopic Surgeons 2006, 10:297. Do AT, Cabbad M, Kerr A, et al.: A warm-up laparoscopic exercise improves the subsequent laparoscopic performance of OB-GYN residents: A low-cost laparoscopic trainer. Journal of Laparoendoscopic Surgeons 2006, 10:297.
23.
Zurück zum Zitat Kahol K, Satava R, Smith M, et al.: The effect of short term pre-trial practice on surgical proficiency in simulated environments: A randomized trial of “Pre-operative warm-up” effect. J Am Coll Surgeons 2008, 208:255–268.CrossRef Kahol K, Satava R, Smith M, et al.: The effect of short term pre-trial practice on surgical proficiency in simulated environments: A randomized trial of “Pre-operative warm-up” effect. J Am Coll Surgeons 2008, 208:255–268.CrossRef
24.
Zurück zum Zitat •• Calatayud D, Arora S, Aggarwal R, et al.: Warm-up in a virtual reality environment improves performance in the operating room. Annals of Surgery 2010, 251:1181–5. This manuscript is noteworthy for two reasons. First, it demonstrates the benefit of virtual reality training for operating room performance (predictive validity), which very rarely is described in the literature because of the difficulty in doing the study. Second, it demonstrates the benefit of a surgical warm-up using simulation technology, which promises to change how surgeons prepare themselves immediately before surgery.PubMedCrossRef •• Calatayud D, Arora S, Aggarwal R, et al.: Warm-up in a virtual reality environment improves performance in the operating room. Annals of Surgery 2010, 251:1181–5. This manuscript is noteworthy for two reasons. First, it demonstrates the benefit of virtual reality training for operating room performance (predictive validity), which very rarely is described in the literature because of the difficulty in doing the study. Second, it demonstrates the benefit of a surgical warm-up using simulation technology, which promises to change how surgeons prepare themselves immediately before surgery.PubMedCrossRef
25.
Zurück zum Zitat Zhang Y, Sweet RM, Metzger GJ, et al.: Advanced finite element mesh model of female SUI research during physical and daily activities. Studies in Health Technology & Informatics 2009, 142:447–52. Zhang Y, Sweet RM, Metzger GJ, et al.: Advanced finite element mesh model of female SUI research during physical and daily activities. Studies in Health Technology & Informatics 2009, 142:447–52.
26.
Zurück zum Zitat Rosen J, Brown JD, De S, et al.: Biomechanical properties of abdominal organs in vivo and postmortem under compression loads. Journal of Biomechanical Engineering 2008, 130:021020-1-17.CrossRef Rosen J, Brown JD, De S, et al.: Biomechanical properties of abdominal organs in vivo and postmortem under compression loads. Journal of Biomechanical Engineering 2008, 130:021020-1-17.CrossRef
27.
Zurück zum Zitat Okamura AM: Haptic feedback in robot-assisted minimally invasive surgery. Current Opinion in Urology 2009, 19:102–7.PubMedCrossRef Okamura AM: Haptic feedback in robot-assisted minimally invasive surgery. Current Opinion in Urology 2009, 19:102–7.PubMedCrossRef
28.
Zurück zum Zitat Reiley CE, Akinbiyi T, Burschka D, et al.: Effects of visual force feedback on robot-assisted surgical task performance. Journal of Thoracic & Cardiovascular Surgery 2008, 135:196–202.CrossRef Reiley CE, Akinbiyi T, Burschka D, et al.: Effects of visual force feedback on robot-assisted surgical task performance. Journal of Thoracic & Cardiovascular Surgery 2008, 135:196–202.CrossRef
29.
Zurück zum Zitat Kitagawa M, Dokko D, Okamura AM, et al.: Effect of sensory substitution on suture-manipulation forces for robotic surgical systems. Journal of Thoracic & Cardiovascular Surgery 2005, 129:151–8.CrossRef Kitagawa M, Dokko D, Okamura AM, et al.: Effect of sensory substitution on suture-manipulation forces for robotic surgical systems. Journal of Thoracic & Cardiovascular Surgery 2005, 129:151–8.CrossRef
30.
Zurück zum Zitat Kapoor A, Li M, Taylor RH: Spatial motion constraints for robot assisted suturing using virtual fixtures. Medical Image Computing & Computer-Assisted Intervention: MICCAI 2005, 889–96. Kapoor A, Li M, Taylor RH: Spatial motion constraints for robot assisted suturing using virtual fixtures. Medical Image Computing & Computer-Assisted Intervention: MICCAI 2005, 889–96.
31.
Zurück zum Zitat Bettini A, Marayong P, Lang S, et al.: Vision-assisted control for manipulation using virtual fixtures. IEEE Transactions on Robotics 2004, 20:953–966.CrossRef Bettini A, Marayong P, Lang S, et al.: Vision-assisted control for manipulation using virtual fixtures. IEEE Transactions on Robotics 2004, 20:953–966.CrossRef
32.
Zurück zum Zitat Ren J, Patel RV, McIsaac KA, et al.: Dynamic 3-D virtual fixtures for minimally invasive beating heart procedures. IEEE Transactions on Medical Imaging 2008, 27:1061–1070.PubMedCrossRef Ren J, Patel RV, McIsaac KA, et al.: Dynamic 3-D virtual fixtures for minimally invasive beating heart procedures. IEEE Transactions on Medical Imaging 2008, 27:1061–1070.PubMedCrossRef
Metadaten
Titel
Surgical Simulation in Pediatric Urologic Education
verfasst von
Thomas Sean Lendvay
Publikationsdatum
01.04.2011
Verlag
Current Science Inc.
Erschienen in
Current Urology Reports / Ausgabe 2/2011
Print ISSN: 1527-2737
Elektronische ISSN: 1534-6285
DOI
https://doi.org/10.1007/s11934-011-0170-8

Weitere Artikel der Ausgabe 2/2011

Current Urology Reports 2/2011 Zur Ausgabe

Männern mit Zystitis Schmalband-Antibiotika verordnen

03.05.2024 Zystitis Nachrichten

Die akute Zystitis von Männern und ihre Therapie sind wenig erforscht. Norwegische Forscher haben das nachgeholt. Ihr Rat: Erst einmal keine Breitbandantibiotika verordnen.

Bestrahlung nach Prostatektomie: mehr Schaden als Nutzen?

02.05.2024 Prostatakarzinom Nachrichten

Eine adjuvante Radiotherapie nach radikaler Prostata-Op. bringt den Betroffenen wahrscheinlich keinen Vorteil. Im Gegenteil: Durch die Bestrahlung steigt offenbar das Risiko für Harn- und Stuhlinkontinenz.

D-Mannose ohne Nutzen in der Prävention von HWI-Rezidiven

D-Mannose, eine Hoffnungsträgerin in der Rezidivprophylaxe von Harnwegsinfektionen, hat in einer Studie nicht mehr bewirken können als ein Placebo. Die Empfehlung zur Einnahme entfalle damit, so die Autoren.

Endlich: Zi zeigt, mit welchen PVS Praxen zufrieden sind

IT für Ärzte Nachrichten

Darauf haben viele Praxen gewartet: Das Zi hat eine Liste von Praxisverwaltungssystemen veröffentlicht, die von Nutzern positiv bewertet werden. Eine gute Grundlage für wechselwillige Ärzte und Psychotherapeuten.

Update Urologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.