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Assessing a new coarctation repair simulator based on real patient’s anatomy

Published online by Cambridge University Press:  04 December 2019

Jacek Kleszcz Open the ORCID record for Jacek Kleszcz [Opens in a new window] ,
Michał Sobieraj ,
Tomasz Nałęcz ,
Patrick O. Myers ,
Michał Wojtalik  and
Wojciech Mrówczyński
Jacek Kleszcz*
Affiliation:
Department of Paediatric Cardiac Surgery, Poznan University of Medical Sciences, Poznan, Poland
Michał Sobieraj
Affiliation:
Department of Paediatric Cardiac Surgery, Poznan University of Medical Sciences, Poznan, Poland
Tomasz Nałęcz
Affiliation:
Department of Paediatric Cardiac Surgery, Poznan University of Medical Sciences, Poznan, Poland
Patrick O. Myers
Affiliation:
Department of Cardio-Vascular Surgery, Geneva University Hospitals, Geneva, Switzerland
Michał Wojtalik
Affiliation:
Department of Paediatric Cardiac Surgery, Poznan University of Medical Sciences, Poznan, Poland
Wojciech Mrówczyński
Affiliation:
Department of Paediatric Cardiac Surgery, Poznan University of Medical Sciences, Poznan, Poland
*
Author for correspondence: J. Kleszcz, Department of Pediatric Cardiac Surgery, Poznan University of Medical Sciences, 27/33, Szpitalna St., 60-572 Poznan, Poland. Tel: +48 618 49 12 77; Fax: +4 618 66 91 30; E-mail: jkleszcz92@gmail.com
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Abstract

Objectives:

To perform the preliminary tests of coarctation of aorta repair trainer, evaluate the surgical properties of the simulation and to assess and enhance residents’ skills.

Methods:

Single patient’s angio-CT anatomy data were converted into magnified 3D-printed model of aortic coarctation with hypoplastic aortic arch, serving for creation of a mould used during wax copies casting. Wax cores were painted with six layers of elastic silicone and melted, yielding phantoms that were consecutively fixed in a mounting with and without a thoracic wall. Simulation included: proximal and distal aortic arch clamping, incision of its lesser curvature, extended end-to-end anastomosis with 7-0 suture. A head-mounted camera video recording enabled anastomosis time and mean one suture bite time evaluation. Leakage assessment was done by a water test.

Results:

Two residents performed nine simulations each. Last four runs were performed with thoracic wall attached. All phantoms performed well, enabling tissue-like handling and cutting, excellent suture retention, and satisfactory elasticity. Median anastomosis times were 22′33″ and 24′47″ for phantoms without and with thoracic wall (p = not significant (NS)). Median times needed to pass suture through one side of anastomosis and regrasp needle were, respectively, 9″ and 13″ (p < 0.001). Median total number of leakages per phantom equalled 2 for both difficulty levels. There were no significant inter-resident differences in all assessed parameters.

Conclusions:

This medium-fidelity aortic coarctation repair trainer showed its feasibility in replication of major critical steps of the real operation. Objective surgical efficiency parameters could be obtained from each simulation and compared between trainees and at different adjustable difficulty levels.

Keywords

Coarctationaortasimulatoreducationtrainingcongenital
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 12 , December 2019 , pp. 1517 - 1521
Copyright
© Cambridge University Press 2019 

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