摘要目的:应用离体猪肾和输尿管进行输尿管软镜培训,评估其可行性和教学价值。方法:选取4对新鲜离体猪肾(含输尿管),在操作台网格中固定,插入输尿管镜鞘建立工作通道,对5名有输尿管硬镜技术基础的学员进行培训,4对肾脏分左右侧轮流操作,每人有8次手术机会,学员在导师指导下完成指定任务。培训结束后导师记录学员手术时间评估学习曲线,判断熟练程度和掌握能力。结果:学员按导师要求完成了培训内容,平均手术时间由最初的54 min (42~71 min) 降到完成第8次手术时的15 min (8~26 min),差异有统计学意义(P＜0.05),在第6次手术后就进入相对稳定的水平。结论:离体猪肾具有价格便宜、操作方便的优点,行输尿管软镜培训直观明了,有利于提高学员临床技能。
Abstract：Objective:To evaluate the feasibility and teaching value of flexible ureteroscopy training using isolated porcine kidneys and ureters in vitro. Methods:Four pairs of isolated porcine kidneys and ureters were placed on the net bar of operation platform and fixed. Ureteroscope access sheath was inserted into ureteral orifice to establish working channel for washing. Five trainees who had rigid ureteroscopy experience began to train from left to right kidneys in turn and finished all the required contents using modular flexible ureteroscope under the supervision of tutor. Each trainee had operation opportunities of 8 times. The learning curve was assessed by recording trainees' operation time after training. Based on these results, we evaluated theirs comprehensibility and proficiency in flexible ureteroscopy indirectly. Results:All trainees finished the training contents of flexible ureteroscopy according to tutor's assignment. The average operation time was shortened from the initial 54 min (42-71 min) to 15 min (8-26 min) (P<0.05). Trainees achieved a relatively stable level after the sixth operation. Conclusions:The isolated porcine kidney was cheaper and convenient for young urologists to practise flexible ureteroscopy. This training model was helpful in improving clinical skills because of its intuitive and realistic features.
胡东亮,刘同族,胡万里,倪栋,王行环. 应用离体猪肾行输尿管软镜培训的方法与研究[J]. 微创泌尿外科杂志, 2014, 3(3): 129-131.
Hu Dongliang,Liu Tongzu,Hu Wanli,Ni Dong,Wang Xinghuan. Development and summary of flexible ureteroscopy training using isolated porcine kidneys. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2014, 3(3): 129-131.
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