A novel surgical training simulator for transanal total mesorectal excision
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ORIGINAL ARTICLE
A novel surgical training simulator for transanal total mesorectal excision S. Imai1 · M. Ito1 Received: 21 April 2020 / Accepted: 7 July 2020 © Springer Nature Switzerland AG 2020
Abstract Background The transanal total mesorectal excision (TaTME) approach for rectal cancer has been gaining popularity. Although TaTME requires specific training, the opportunity to obtain this training is limited. We developed the first dry simulator that includes some important structural landmarks to provide training that includes all the procedural steps of TaTME. Methods The model was structured based on a computed tomography scan data. The simulator mimics the rectum and surrounding key anatomical structures. All material components were made of polyvinyl alcohol and stained with various colors to easily identify these anatomical structures while undergoing the training. Results Our simulator is compact in its size and can be easily packed, stacked, and stored. The materials mimic the real one and the model allows us to perform the entire step-by-step TaTME procedures with genuine clinical devices from the attachment of operative platform to the anastomosis. We have held the course 24 times to date, with more than 200 surgeons participating not only from domestic hospitals but also from other countries. The result of the satisfaction survey from 65 participants, which was rated from 0 to 10 points, was an average score of 8.6 (± 1.4) points. Conclusions We present the world’s first TaTME simulator and believe that it will play an important role for the safe spread of TaTME surgery. Keywords Transanal total mesorectal excision · Laparoscopic surgery · Training · Simulator · Rectal cancer
Introduction Even for experts in colorectal surgery, laparoscopic resection for lower rectal disease is challenging. Transanal total mesenteric excision (TaTME) has gained popularity globally over the past 10 years. TaTME can provide surgeons several advantages such as good visualization of the narrow pelvic cavity and easy handling of linear manipulation from below. Similar to robotic surgery, TaTME has been reported to be useful especially for male and obese patients and those with lower or bulky rectal tumors [1]. However, TaTME requires specific training because it involves an unfamiliar anatomical orientation from the anal side and an intricate surgical technique. A cadaveric training course is a good method to learn these skills, but the opportunity to obtain this training is limited despite the proposal of a structured TaTME * M. Ito [email protected] 1
Department of Colorectal Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
training curriculum [2, 3]. To address difficulties regarding access for training in TaTME procedures, we developed the first dry simulator that includes some important structural landmarks to provide training that includes all the procedural steps of TaTME.
Materials and methods Three-dimensional (3D) printer technology was initially used to create a pelvic simu
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