Critical design and validation considerations for the development of neonatal minimally invasive surgery simulators.


Journal

Journal of pediatric surgery
ISSN: 1531-5037
Titre abrégé: J Pediatr Surg
Pays: United States
ID NLM: 0052631

Informations de publication

Date de publication:
Nov 2019
Historique:
received: 05 12 2018
revised: 16 05 2019
accepted: 31 05 2019
pubmed: 20 6 2019
medline: 28 2 2020
entrez: 20 6 2019
Statut: ppublish

Résumé

Pediatric surgical trainees have limited exposure to advanced minimally invasive surgery (MIS) during their clinical training, particularly for cases such as esophageal atresia/tracheoesophageal fistula (EA/TEF). Simulation on validated neonatal models offers an alternative means of training that may augment traditional forms of training; but to be useful, they must fulfill certain criteria. Review of the currently available MIS, thoracoscopic and laparoscopic, simulators for pediatric surgery, and identification of those factors that contribute to their fidelity and validity as a training tool that must be incorporated in the design of future simulation models. There are few neonatal laparoscopic and thoracoscopic models currently available, or in the research stage. To our knowledge, there is no commercially available, synthetic, high fidelity and low cost thoracoscopic model in existence. Use of animal tissue has disadvantages of ethical dilemmas, cost, and logistic and procurement issues. Newer synthetic models need to be validated for fidelity, to replicate those components of the operation that pose the greatest technical challenge, and incorporate means of measuring acquisition of technical expertise. This review describes the principles that need to be considered to develop low cost, validated high-fidelity MIS simulator that can be used for training, and that is capable of measuring the acquisition of the technical skills that can be applied to the repair of complex procedures such as esophageal atresia. Level of evidence III.

Sections du résumé

BACKGROUND/PURPOSE OBJECTIVE
Pediatric surgical trainees have limited exposure to advanced minimally invasive surgery (MIS) during their clinical training, particularly for cases such as esophageal atresia/tracheoesophageal fistula (EA/TEF). Simulation on validated neonatal models offers an alternative means of training that may augment traditional forms of training; but to be useful, they must fulfill certain criteria.
METHODOLOGY METHODS
Review of the currently available MIS, thoracoscopic and laparoscopic, simulators for pediatric surgery, and identification of those factors that contribute to their fidelity and validity as a training tool that must be incorporated in the design of future simulation models.
RESULTS RESULTS
There are few neonatal laparoscopic and thoracoscopic models currently available, or in the research stage. To our knowledge, there is no commercially available, synthetic, high fidelity and low cost thoracoscopic model in existence. Use of animal tissue has disadvantages of ethical dilemmas, cost, and logistic and procurement issues. Newer synthetic models need to be validated for fidelity, to replicate those components of the operation that pose the greatest technical challenge, and incorporate means of measuring acquisition of technical expertise.
CONCLUSION CONCLUSIONS
This review describes the principles that need to be considered to develop low cost, validated high-fidelity MIS simulator that can be used for training, and that is capable of measuring the acquisition of the technical skills that can be applied to the repair of complex procedures such as esophageal atresia. Level of evidence III.

Identifiants

pubmed: 31213289
pii: S0022-3468(19)30390-2
doi: 10.1016/j.jpedsurg.2019.05.022
pii:
doi:

Types de publication

Journal Article Review Validation Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

2448-2452

Informations de copyright

Copyright © 2019 Elsevier Inc. All rights reserved.

Auteurs

David Nair (D)

University of Otago, Christchurch, New Zealand. Electronic address: naida561@student.otago.ac.nz.

Jonathan M Wells (JM)

Department of Paediatric Surgery, Canterbury, District Health Board, New Zealand.

Nick Cook (N)

Department of Medical physics and Bioengineering, Canterbury, District Health Board, New Zealand.

Ash Moorhead (A)

Department of Medical physics and Bioengineering, Canterbury, District Health Board, New Zealand.

Spencer W Beasley (SW)

University of Otago, Christchurch, New Zealand; Department of Paediatric Surgery, Canterbury, District Health Board, New Zealand.

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Classifications MeSH