scholarly journals Techniques: Utility of a 3D printed bladder model for teaching minimally invasive urethrovesical anastomosis

2017 ◽  
Vol 11 (7) ◽  
pp. E321-2 ◽  
Author(s):  
Nathan C. Wong ◽  
Jen Hoogenes ◽  
Yanbo Guo ◽  
Mackenize A. Quantz ◽  
Edward D. Matsumoto
Keyword(s):  
Minimally Invasive ◽  
Resident Education ◽  
Learning Curves ◽  
Steep Learning Curve ◽  
Resident Work ◽  
Hands On ◽  
Competency Based ◽  
3D Printed ◽  
Resident Work Hours ◽  
Bench Model

The urethrovesical anastomosis (UVA) is one of the most challenging steps during a minimally invasive radical prostatectomy. Not surprisingly, minimally invasive, in particular laparoscopic, prostatectomy is associated with a steep learning curve.1 With competency-based training on the horizon, as well as the recent reduction in resident work hours, surgical educators have shifted some training outside of the operating room into surgical skills labs. To reduce learning curves and improve resident education at our centre, we use a hands-on 3D printed bladder bench model to emulate the UVA task during a minimally invasive prostatectomy.

Competency-Based Education in Minimally Invasive and Robotic Colorectal Surgery

2021 ◽  
Vol 34 (03) ◽  
pp. 155-162
Author(s):  
Marisa Louridas ◽  
Sandra de Montbrun
Keyword(s):  
Minimally Invasive ◽  
Technical Skill ◽  
Assessment Tools ◽  
Independent Practice ◽  
Competency Based Education ◽  
The Past ◽  
Robotic Colorectal Surgery ◽  
Competency Based ◽  
Colorectal Surgeons ◽  
Educational Paradigm

AbstractMinimally invasive and robotic techniques have become increasingly implemented into surgical practice and are now an essential part of the foundational skills of training colorectal surgeons. Over the past 5 years there has been a shift in the surgical educational paradigm toward competency-based education (CBE). CBE recognizes that trainees learn at different rates but regardless, are required to meet a competent threshold of performance prior to independent practice. Thus, CBE attempts to replace the traditional “time” endpoint of training with “performance.” Although conceptually sensible, implementing CBE has proven challenging. This article will define competence, outline appropriate assessment tools to assess technical skill, and review the literature on the number of cases required to achieve competence in colorectal procedures while outlining the barriers to implementing CBE.

Fatigue, Resident Work Hours, and Safety

Medical Care ◽  
2009 ◽  
Vol 47 (7) ◽  
pp. 711-713
Author(s):  
David W. Bates
Keyword(s):  
Work Hours ◽  
Resident Work ◽  
Resident Work Hours

Systematic Review: Effects of Resident Work Hours on Patient Safety

2004 ◽  
Vol 141 (11) ◽  
pp. 851 ◽  
Author(s):  
Kathlyn E. Fletcher ◽  
Steven Q. Davis ◽  
Willie Underwood ◽  
Rajesh S. Mangrulkar ◽  
Laurence F. McMahon ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Safety ◽  
Work Hours ◽  
Resident Work ◽  
Resident Work Hours

Restricting resident work hours

2012 ◽  
Vol 40 (8) ◽  
pp. 2532-2533
Author(s):  
Adam Peets ◽  
Najib Ayas
Keyword(s):  
Work Hours ◽  
Resident Work ◽  
Resident Work Hours

Application of a Viscous Liquid as an Aerosol for Post-Operative Adhesion Prevention: First Engineering Steps Towards Nozzle Design

2020 ◽  
Author(s):  
P. Alex Smith ◽  
Timothy J. Keane ◽  
Stefano Serpelloni ◽  
Stephen G. Ramon ◽  
Francesca Taraballi
Keyword(s):  
Thin Film ◽  
Minimally Invasive ◽  
Viscous Liquid ◽  
Scar Tissue ◽  
Adhesion Prevention ◽  
Nozzle Design ◽  
Postoperative Adhesions ◽  
Internal Organs ◽  
Spray Pattern ◽  
3D Printed

Abstract Postoperative adhesions are scar tissue that form between internal organs after surgery, leading to devastating life-long complications. Current adhesion barriers used clinically are solid sheets which can only be applied in open surgeries through large incisions. We have developed a material which can be applied as a liquid in minimally invasive surgeries which transitions into a solid thin film barrier upon contact with warm tissue. However, to be effective, it must be sprayed, and spraying a viscous liquid consistently is challenging. We proposed using a gas dispersant to facilitate aerosolization. In this study, we compared a commercially available nozzle without gas dispersant to a custom 3D printed nozzle with gas dispersant. For comparison, we measured both spray pattern and stiffness of the resulting gel. We found that when sprayed with gas dispersant, the spray pattern covered a larger area, and the resulting gel was stiffer than when sprayed without gas dispersant.

Learning curves for transradial access versus transfemoral access in diagnostic cerebral angiography: a case series

2021 ◽  
pp. neurintsurg-2021-017460
Author(s):  
Michael K Tso ◽  
Gary B Rajah ◽  
Rimal H Dossani ◽  
Michael J Meyer ◽  
Matthew J McPheeters ◽  
...  
Keyword(s):  
Learning Curve ◽  
Case Series ◽  
Learning Curves ◽  
Fluoroscopy Time ◽  
Access Site ◽  
Steep Learning Curve ◽  
Transradial Access ◽  
Primary Operator ◽  
Technical Proficiency ◽  
Over Time

BackgroundThe perception of a steep learning curve associated with transradial access has resulted in its limited adoption in neurointervention despite the demonstrated benefits, including decreased access-site complications.ObjectiveTo compare learning curves of transradial versus transfemoral diagnostic cerebral angiograms obtained by five neurovascular fellows as primary operator.MethodsThe first 100–150 consecutive transradial and transfemoral angiographic scans performed by each fellow between July 2017 and March 2020 were identified. Mean fluoroscopy time per artery injected (angiographic efficiency) was calculated as a marker of technical proficiency and compared for every 25 consecutive procedures performed (eg, 1–25, 26–50, 51–75).ResultsWe identified 1242 diagnostic angiograms, 607 transradial and 635 transfemoral. The radial cohort was older (64.3 years vs 62.3 years, p=0.01) and demonstrated better angiographic efficiency (3.4 min/vessel vs 3.7 min/vessel, p=0.03). For three fellows without previous endovascular experience, proficiency was obtained between 25 and 50 transfemoral angiograms. One fellow achieved proficiency after performing 25–50 transradial angiograms; and the two other fellows, in <25 transradial angiograms. The two fellows with previous experience had flattened learning curves for both access types. Two patients experienced transient neurologic symptoms postprocedure. Transradial angiograms were associated with significantly fewer access-site complications (3/607, 0.5% vs 22/635, 3.5%, p<0.01). Radial-to-femoral conversion occurred in 1.2% (7/607); femoral-to-radial conversion occurred in 0.3% (2/635). Over time, the proportion of transradial angiographic procedures increased.ConclusionTechnical proficiency improved significantly over time for both access types, typically requiring between 25 and 50 diagnostic angiograms to achieve asymptomatic improvement in efficiency. Reduced access-site complications and decreased fluoroscopy time were benefits associated with transradial angiography.

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