Reperfused human cadaver as a new simulation model for colonoscopy: a pilot study.


Journal

Surgical endoscopy
ISSN: 1432-2218
Titre abrégé: Surg Endosc
Pays: Germany
ID NLM: 8806653

Informations de publication

Date de publication:
04 2023
Historique:
received: 02 09 2022
accepted: 06 11 2022
medline: 11 4 2023
pubmed: 29 11 2022
entrez: 28 11 2022
Statut: ppublish

Résumé

The reperfused human cadaver is a validated simulator for surgery. We aimed to use it as a colonoscopy simulator. Novices, intermediates and skilled participants in gastrointestinal endoscopy were included. They performed one colonoscopy on a reperfused human cadaver and reaching rates, time, and length needed to reach anatomical landmarks were reported for construct validity analysis. We also assessed our model realism (SRS survey), educational content (CVS survey) and task load (NASA-TLX index). Score items were collected and defined as "favorable" when items were rated ≥ 5/7 with an inter-quartile range (IQR) overlapping four, and "very favorable" when rated ≥ 5/7 with an IQR excluding four (neutral). Primary endpoints were the rectosigmoid junction (RSJ) reaching rate and the descending colon (DC) reaching time. Secondary objectives were SRS, CVS and NASA-TLX questionnaire results. A total of 11 skilled participants, 5 intermediates and 8 novices were included. Skilled participants reached RSJ more often than novice and intermediary groups, respectively, 100%, 80% and 75% without differing significantly. They reached DC more frequently (100% for skilled, 80% for intermediates and 50% for novices, p = 0.018). The median time to reach RSJ (59, 272 and 686 s for skilled, intermediates and novices group, respectively) and DC (90, 534 and 1360 s for skilled, intermediates and novices) was significantly shorter for skilled participants (both p < .01). Nineteen out of the 22 items composing the realism survey obtained "very favorable" and "favorable" scores. Educational content was designated as "very favorable". Mental, physical, and technical demands were gradually higher the lower the initial level of experience. Reperfused human cadaver model has the potential to be valid simulation tool for diagnostic colonoscopy training.

Sections du résumé

BACKGROUND
The reperfused human cadaver is a validated simulator for surgery. We aimed to use it as a colonoscopy simulator.
METHODS
Novices, intermediates and skilled participants in gastrointestinal endoscopy were included. They performed one colonoscopy on a reperfused human cadaver and reaching rates, time, and length needed to reach anatomical landmarks were reported for construct validity analysis. We also assessed our model realism (SRS survey), educational content (CVS survey) and task load (NASA-TLX index). Score items were collected and defined as "favorable" when items were rated ≥ 5/7 with an inter-quartile range (IQR) overlapping four, and "very favorable" when rated ≥ 5/7 with an IQR excluding four (neutral). Primary endpoints were the rectosigmoid junction (RSJ) reaching rate and the descending colon (DC) reaching time. Secondary objectives were SRS, CVS and NASA-TLX questionnaire results.
RESULTS
A total of 11 skilled participants, 5 intermediates and 8 novices were included. Skilled participants reached RSJ more often than novice and intermediary groups, respectively, 100%, 80% and 75% without differing significantly. They reached DC more frequently (100% for skilled, 80% for intermediates and 50% for novices, p = 0.018). The median time to reach RSJ (59, 272 and 686 s for skilled, intermediates and novices group, respectively) and DC (90, 534 and 1360 s for skilled, intermediates and novices) was significantly shorter for skilled participants (both p < .01). Nineteen out of the 22 items composing the realism survey obtained "very favorable" and "favorable" scores. Educational content was designated as "very favorable". Mental, physical, and technical demands were gradually higher the lower the initial level of experience.
CONCLUSIONS
Reperfused human cadaver model has the potential to be valid simulation tool for diagnostic colonoscopy training.

Identifiants

pubmed: 36443563
doi: 10.1007/s00464-022-09763-0
pii: 10.1007/s00464-022-09763-0
pmc: PMC9707156
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

3224-3232

Informations de copyright

© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Auteurs

A Rohr (A)

Gastroenterology and Digestive Oncology Department, Centre Hospitalier Universitaire de Reims, Hospital Robert Debré, Rue du Général Koenig, 51100, Reims, France.

C Perrenot (C)

Anatomy Department, Université de Reims Champagne Ardenne, Reims, France.
Digestive and Endocrine Surgery, Centre Hospitalier Universitaire de Reims, Reims, France.

A Pitta (A)

Gastroenterology and Digestive Oncology Department, Centre Hospitalier Universitaire de Reims, Hospital Robert Debré, Rue du Général Koenig, 51100, Reims, France.

I Celerier (I)

Anatomy Department, Université de Reims Champagne Ardenne, Reims, France.

M Labrousse (M)

Anatomy Department, Université de Reims Champagne Ardenne, Reims, France.
Department of Otorhinolaryngology, Head and Neck Surgery, Centre Hospitalier Universitaire de Reims, Reims, France.

Y Renard (Y)

Anatomy Department, Université de Reims Champagne Ardenne, Reims, France.
Digestive and Endocrine Surgery, Centre Hospitalier Universitaire de Reims, Reims, France.

G Cadiot (G)

Gastroenterology and Digestive Oncology Department, Centre Hospitalier Universitaire de Reims, Hospital Robert Debré, Rue du Général Koenig, 51100, Reims, France.
Anatomy Department, Université de Reims Champagne Ardenne, Reims, France.

M Brugel (M)

Gastroenterology and Digestive Oncology Department, Centre Hospitalier Universitaire de Reims, Hospital Robert Debré, Rue du Général Koenig, 51100, Reims, France. mbrugel@chu-reims.fr.

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