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目的应用离体猪肾构建模拟腹腔镜肾部分切除术培训模型,并对培训模型进行评价。方法将新鲜猪肾在肾纤维囊外去除脂肪等组织,在猪肾表面盖两个同心圆圈,小圈内径约28 mm,大圈32 mm,随后操作时将猪肾固定在人体塑料模型内。高级组6名、中级组6名、初级组8名进行腹腔镜下肾部分切除的操作,记录数据并进行统计分析。随后高级职称医师对模型进行Likert评分表评分,对离体猪肾解剖结构条件、操作质感、外观及颜色、模型总体的逼真情况等方面进行评价。结果 Likert评分中,模型解剖条件为5.00±0.00;操作质感为4.33±0.52;外观及颜色为4.33±0.52;模型总体逼真情况为4.67±0.52。初、中、高级组人员在第一次肾部分切除术的肾脏部分切除时间、缝合时间、内外圈损伤数、缝合后切缘间隙距离等指标有统计学差异。结论此培训模型具有简便、经济、手术模拟逼真度高等优点,可用于腹腔镜肾部分切除的高级培训。
Objective To study the model of laparoscopic partial nephrectomy with porcine kidney in vitro and to evaluate the training model. Methods Fresh porcine kidney was used to remove fat and other tissues outside the renal fibrous capsule. Two concentric circles were covered on the porcine kidney surface. The inner diameter of the small circle was about 28 mm and the inner diameter of the large circle was 32 mm. The porcine kidney was then fixed in a human plastic model. 6 in the advanced group, 6 in the intermediate group, and 8 in the primary group underwent laparoscopic partial nephrectomy. The data were recorded and statistically analyzed. Followed by senior professional physician Likert score scale score on the model, the ex-vivo anatomical structure of pigs and kidneys, texture, appearance and color of the operation, the actual situation of the overall model for evaluation. Results In the Likert score, the model anatomic condition was 5.00 ± 0.00; operation texture was 4.33 ± 0.52; appearance and color was 4.33 ± 0.52; and the overall lifelikeness of the model was 4.67 ± 0.52. There were significant differences in the partial nephrectomy time, the time of suture, the number of injury between the inner and outer rings, the distance of the margin of the incision after the first partial nephrectomy in the primary, middle and senior group. Conclusion This training model has the advantages of simple, economical, high simulation fidelity and can be used for advanced training of laparoscopic partial nephrectomy.