New Trainer for Video-Assisted Thoracic Surgery Lobectomy

Abstract

Background: Only a few simulators are available which offer training in video-assisted thoracic surgery (VATS). We have developed a VATS training model for surgeons. Methods: The simulator consists of a training module housing three disposable components: the lung (made of polyurethane), the bronchus, and the artificial circulatory pulmonary vessels (made of polyvinyl chloride), connected to a pump. VATS procedures were videotaped and evaluated using a checklist assessment method. Results: This unique module has been tested at several VATS seminars in Japan. In the questionnaire, training participants strongly agreed that the trainer was helpful and prepared them well for VATS lobectomy prior to performing actual surgery. Evaluation of the dexterity score for thoracoscopic surgery with our simulator correlated with the surgeons' experience with actual surgery. Technical factors were well taught using this model. Conclusions: Our unique trainer may enhance the skill of VATS surgeons at a national level.

thoracic education - training - VATS simulator

References

• 1 Munz Y, Kumar D, Bann S, Darzi A. Laparoscopic virtual reality and box trainers. Is one superior to the other?.  Surg Endosc. 2004;  18 485-494
• 2 Youngblood P L, Srivastava S, Heinrichs W L, Dev P, Wren S M. Comparison of training on two laparoscopic simulators and assessment of skills transfer to surgical performance.  J Am Coll Surg. 2005;  200 546-551
• 3 Roviaro G, Varoli F, Vergani C, Nucca O, Maciocco M, Grignani F. Long-term survival after videothoracoscopic lobectomy for stage I lung cancer.  Chest. 2004;  126 725-732
• 4 Iwasaki A, Shirakusa T, Shiraishi T, Yamamoto S. Results of video-assisted thoracic surgery for stage I/II non-small cell lung cancer.  Eur J Cardiothorac Surg. 2004;  26 158-164
• 5 Park B J, Flores F M, Rusch V W. Robotic assistance for video-assisted thoracic surgical lobectomy: technique and initial results.  J Thorac Cardiovasc Surg. 2006;  131 19-20
• 6 Ohtsuka T, Nomori H, Horio H, Naruke T, Suematsu K. Is major pulmonary resection by video-assisted thoracic surgery an adequate procedure in clinical stage I lung cancer?.  Chest. 2004;  125 1742-1746
• 7 Daniels L J, Balderson S S, Mark P A‐C, Onaitis M W, D'Amoco T A. Thoracoscopic lobectomy: a safe and effective strategy for patients with stage I lung cancer.  Ann Thorac Surg. 2002;  74 860-864
• 8 Blum M G, Powers T W, Sundaresan S. Bronchoscopy simulator prepares junior residents to completely perform basic clinical bronchoscopy.  Ann Thorac Surg. 2004;  78 289-291
• 9 Martin-Ucar A E, Chetty G K, Vaughan R, Waller D A. A prospective audit evaluating the role of video-assisted cervical mediastinoscopy (VAM) as a training tool.  Eur J Cardiothorac Surg. 2004;  26 393-395
• 10 Shigemura N, Akashi A, Funaki S, Nakagiri T, Inoue M, Sawabata N, Shiono H, Minami M, Takeuchi Y, Okamura M, Sawa Y. Long-term outcomes after a variety of video-assisted thoracoscopic lobectomy approaches for clinical stage IA lung cancer: a multi-institutional study.  J Thorac Cardiovasc Surg. 2006;  132 464-465
• 11 Thomas P, Doddoli C, Yena S, Thirion X, Sebag F, Fuentes P, Giudicelli R. VATS is an adequate oncological operation for stage I non-small cell lung cancer.  Eur J Cardiothorac Surg. 2002;  21 1094-1099
• 12 Balduck B, Hendriks J, Lauwers P, Van Schil P. Quality of life evolution after lung cancer surgery: a prospective study in 100 patients.  Lung Cancer. 2007;  56 423-431
• 13 Nagahiro I, Ando A, Aoe M, Sano Y, Sate H, Shimizu N. Pulmonary function, postoperative pain, and serum cytokine level after lobectomy: a comparison of VATS and conventional procedure.  Ann Thorac Surg. 2001;  72 362-365
• 14 Li W WL, Lee R LM, Lee T W, Ng C SH, Shioe A DL, Wan I YP, Arifi A AA, Yim A PC. The impact of thoracic surgical access on early shoulder function: video-assisted thoracic surgery versus posterolateral thoracotomy.  Eur J Cardiothorac Surg. 2003;  23 390-396
• 15 Grantcharov T P, Kristiansen V B, Bendix J, Bardram L, Rosenberg J, Funch-Jansen P. Randomized clinical trial of virtual reality simulation for laparoscopic skills training.  Br J Surg. 2004;  91 146-150
• 16 Uchal M, Raftopoulos Y, Tjugum J, Bergamaschi R. Validation of six-task simulation model in minimally invasive surgery.  Surg Endosc. 2005;  19 109-116
• 17 Martling A, Holm T, Rutqvist L E, Johansson H, Moran B J, Heald R J, Cedermark B. Impact of surgical training programme on rectal cancer outcomes in Stockholm.  Br J Surg. 2005;  92 225-229
• 18 Ng T, Ryder B A. Evolution to video-assisted thoracic surgery lobectomy after training: initial results of the first 30 patients.  J Am Coll Surg. 2006;  203 551-557
• 19 Reuthebuch O, Lang A, Groscurth P, Lachat M, Turina M, Zünd G. Advanced training model for beating heart coronary artery surgery: the Zurich heart-trainer.  Eur J Cardiothorac Surg. 2002;  22 244-248
• 20 McKenna R J, Houck W, Fuller C B. Video-assisted thoracic surgery lobectomy: experience with 1100 cases.  Ann Thorac Surg. 2006;  81 421-425
• 21 Ferguson J, Walker W. Developing a VATS lobectomy programme - can VATS lobectomy be taught?.  Eur J Cardiothorac Surg. 2006;  29 806-809