Application of "the household tissue paper method" in the teaching of laparoscopic technique
Ma Chong1, Teng Jingfei1, Gao Feng2, GuanYawei1, Yao Li2, Ai Xing1,*
1Department of Urology,the Third Medical Centre,Chinese PLA General Hospital,Beijing 100039,China; 2Department of Urology,the Seventh Medical Centre,Chinese PLA General Hospital,Beijing100010,China
摘要目的:探讨一种基于家用抽取式纸巾的训练方法在腹腔镜技术教学中的效果。方法:将12名低年资住院医师,随机分成A、B两组,每组6名。A组通过“家用纸巾训练法”,指导学员进行粘连松解、层面分离等腹腔镜操作。B组通过商品化的腹腔镜训练器材,练习传统的夹豆、剪纸操作。训练两周,共10h。由高年资主诊医师在实际腹腔镜精索静脉高位结扎术中,比较两组学员腹腔镜操作技术GOALS评分和单侧精索完全游离所需时间。结果:两组学员年龄、性别、培训前GOALS评分差异无统计学意义（P>0.05）。A组相比B组动作有效性[（3.0±0.3） vs. （2.2±0.2）分, P=0.02]、器械使用能力[（3.2±0.4） vs. （2.2±0.2）分, P=0.04]、独立完成能力[（3.8±0.3) vs. (2.2±0.3）分, P<0.01]、趣味性评分[（4.5±0.2） vs. （3.0±0.3）分, P<0.01]、GOALS总分[（17.7±1.3） vs. （13.8±0.5）分, P=0.02]高,游离单侧精索用时少[（11.8±1.7）min vs. （17.3±1.7）min, P=0.04]。结论: “家用纸巾训练法”是一种经济、便捷、有效的腹腔镜操作训练方法,尤其适用于腹腔镜手术中层面分离技术的教学和培训。
Abstract：Objective: To investigate the effectiveness of a training method based on household tissue paper in teaching laparoscopic techniques. Methods: Twelve junior resident surgeons were randomly assigned to either group A or B with six patients in each group. Group A was instructed in adhesion loosening and layer separation laparoscopically by the “home tissue training method”. Group B practiced traditional bean-grasping and paper-cutting procedures with commercially available laparoscopic training equipment. After the 10-hour training within two weeks, senior attending surgeons recorded the GOALS scores and the time required for unilateral spermatic cord isolation in each trainee during actual laparoscopic high-grade ligation of the spermatic vein. Results: There was no significant difference in age, gender, or pretraining GOALS scores between two groups （P>0.05）. However,actione ffectiveness[（3.0±0.3） vs. （2.2±0.2）points,P=0.02], instrumentation ability[（3.2±0.4） vs. （2.2±0.2）points,P=0.04],independent completion ability[（3.8±0.3） vs. （2.2±0.3）points, P<0.01], amusement score [（4.5±0.2） vs. （3.0±0.3）points, P<0.01], and total GOALS score[（17.7±1.3） vs. （13.8±0.5）points, P=0.02] were significant higher in group A compared with group B. Moreover, Group A took less time to isolate unilateral spermatic cord[（11.8±1.7） min vs. （17.3±1.7）min, P=0.04]. Conclusion: The "household tissue paper method" is an economical, convenient, and effective method for laparoscopic operation training, especially for teaching and practicing the fascia separation technique in laparoscopic surgery.
马重, 滕竞飞, 高峰, 关亚伟, 姚丽, 艾星. 腹腔镜技术教学中“家用纸巾训练法”的应用研究[J]. 微创泌尿外科杂志, 2022, 11(6): 377-380.
Ma Chong, Teng Jingfei, Gao Feng, GuanYawei, Yao Li, Ai Xing. Application of "the household tissue paper method" in the teaching of laparoscopic technique. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2022, 11(6): 377-380.
[1] Alkatout I, Mechler U, Mettler L, et al. The development of laparoscopy-ahistorical overview[J]. Front Surg, 2021, 8:799442.
[2] Hafford ML, Van Sickle KR, Willis RE, et al. Ensuring competency: are fundamentals of laparoscopic surgery training and certification necessary for practicing surgeons and operating room personnel?[J] Surg Endosc, 2013,27(1): 118-126.
[3] Tjiam IM, Persoon MC, Hendrikx AJ, et al. Program for laparoscopic urologic skills: a newly developed and validated educational program[J]. Urology, 2012,79(4): 815-820.
[4] Valdivieso RF, Zorn KC. Surgery: urological laparoscopic training--practice makes perfect[J]. Nat Rev Urol, 2014,11(3): 138-139.
[5] Vassiliou MC, Feldman LS, Andrew CG, et al. A global assessment tool for evaluation of intraoperative laparoscopic skills[J]. Am J Surg, 2005, 190(1): 107-113.
[6] Satava RM. Surgical education and surgical simulation[J]. World J Surg, 2001, 25(11): 1484-1489.
[7] Bonrath EM, Weber BK, Fritz M, et al. Laparoscopic simulation training: Testing for skill acquisition and retention[J]. Surgery, 2012,152(1): 12-20.
[8] 崔振宇,郭景阳,杨帆,等. 3D 打印技术在泌尿外科肾脏占位性疾病规范化培训中的应用[J]. 中国毕业后教育, 2022,4(5): 465-468.
[9] Bielsa VF. Virtual reality simulation in plastic surgery training. Literature review[J]. J Plast Reconstr Aesthet Surg, 2021,74(9): 2372-2378.
[10] Yu P, Pan J, Wang Z, et al. Quantitative influence and performance analysis of virtual reality laparoscopic surgical training system[J]. BMC Med Educ, 2022,22(1): 92-101.
[11] Ulrich AP, Cho MY, Lam C, et al. A low-cost platform for laparoscopic simulation training[J]. Obstet Gynecol, 2020,136(1): 77-82.
[12] 杨波,肖亮,王辉清,等. 泌尿外科腹腔镜手术技能训练模型的开发和应用体会[J]. 微创泌尿外科杂志, 2013,2(1): 8-10.
[13] Ulusoy O, Karakus OZ, Ates O, et al. Successful outcomes in adolescent varicocele treatment with high-level laparoscopic varicocelectomy[J]. J Pediatr Surg, 2020, 55(8): 1610-1612.
[14] 王保军,黄庆波,李新涛,等. 腹腔镜肾部分切除术的多模培训模式[J]. 微创泌尿外科杂志, 2016,5(4): 249-252.
