Training on operation skills of simulation training box
Animal experiment training
After mastering the basic operation skills of various laparoscopic operations in the training box, animal operation experiments can be carried out. The main purpose is to be familiar with the basic skills of pneumoperitoneum establishment, tissue separation, exposure, ligation, suture and hemostasis; Be familiar with the use of various special instruments in vivo and the operation of various organs in vivo; Further strengthen the operation cooperation between the operator and the assistant.
Generally, larger animals such as pigs or dogs are selected. First, the patients were anesthetized by intraperitoneal injection, then the skin was prepared, the venous channel was established, and the anesthesiologist gave endotracheal intubation inhalation anesthesia, and then the body position was fixed.
Usually take the supine position.
Practice puncture and incision to establish pneumoperitoneum
After pneumoperitoneum is formed, the first is the training of abdominal organs and orientation recognition. Confirming theposition of various internal organs under laparoscopy on the monitor is an important step in the implementation of surgery. This is not difficult for doctors who have mastered anatomical knowledge and conventional surgery, but the images obtained through the TV monitoring system are equivalent to those seen by monocular vision and lack three-dimensional sense, so it is easy to make errors in judging the distance, which still needs some adaptation training in practice. In the whole process of laparoscopic surgery, it is very important for the assistant holding the mirror to ensure the correct direction of the surgical field of vision, otherwise it will lead to the wrong judgment of the operator. Next, practice puncturing other cannulas with the help of laparoscopy.
Practice laparoscopic ureterotomy and suture, laparoscopic nephrectomy and laparoscopic partial cystectomy as needed. Hemostatic techniques should be the focus of training. In the final stage of surgery, blood vessels can be deliberately damaged and various hemostatic methods can be practiced.
Clinical learning
After passing the training of the above simulation training box and animal experiment, the trainees are basically familiar with various instruments of laparoscopic surgery and master the basic operation skills of laparoscopic surgery. The next step is to enter the clinical learning stage. Trainees will be arranged to visit all kinds of urological laparoscopic surgery and be familiar with the special body position and approach of common urological laparoscopic surgery. Then he went to the stage to hold the mirror for experienced laparoscopic surgeons, gradually transition to being able to cooperate with the operation smoothly, and began to complete relatively simple laparoscopic operations under the guidance of superior doctors, such as laparoscopic spermatic vein ligation.
Post time: May-20-2022
