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A training model in thoracoscopic surgery for esophageal atresia

Hossein Allal

CHU Lapeyronie Structure de Chirurgie Viscérale Pédiatrique, Montpellier, France



Introduction: Through time, the training and development of technical skills have been performed in the operating room. Clinical training using simulated environments may improve the efficiency and safety of laparoscopic surgery. We present a training model in laparoscopic surgery for esophageal atresia (EA).
Material and methods: To confine the training model, we divide it in three parts: A) Video surgery equipment. A video endoscopic unit with an image integrated module, three 3.5mm trocar, one 5.5 mm trocar, 3mm instruments. B) A doll is used, which simulated a term newborn having a longitudinal anterior and posterior opening of 10 cms long and 2cms wide, through which a separator is introduced. C). Rabbit tissue or synthetic material are used. We proceed to place the videosurgery unit just like a real procedure. Placing the optic, visualizes the first image of esophagus and trachea. Afterwards, performing a meticulous dissection the separation of the tracheoesophagean partition is done, a suture thread 5/0 is placed around the esophagus, making an intracorporeal knot. The same surgical technique, end to end anastomosis is performed.
Conclusion: Since the beginning of laparoscopy, the use of simulators have proven a great potential for training and acquiring skills, shortening the learning curve and the early use in real procedures. This model which perfectly simulates the environment of an EA has been used by pediatric surgeons in the unit, allowing them to acquire skills that could then be applied during surgery