Animal models as educational tools in laparoscopic colorectal surgery.
Laparoscopic colectomies have been shown to be feasible in patients with low morbidity. Thus, many surgeons, as they begin to perform laparoscopic surgery on other areas of the abdomen, may consider performing laparoscopic colectomies. Although certain basic skills like suturing and knot tying can be practiced in training models, the preclinical performance of intraperitoneal bowel mobilization and anastomosis, dissection of mesentery, and control of bleeding can only be practiced and perfected in live animal models. We describe several laparoscopic intestinal techniques in porcine and canine models. Through use of these procedures, the surgeon can learn to handle intraperitoneal organs atraumatically, to achieve hemostasis, to dissect mesentery with lymphadenectomy and high ligation of major vessels, and to accomplish a variety of intraperitoneal anastomoses. Acquisition of these skills is essential in the quest to perform successful laparoscopic intestinal surgery. These skills cannot be learned in inanimate training models.
Böhm
B
B
Department of Colorectal Surgery, Cleveland Clinic Foundation, OH 44195.
Milsom
J W
JW
D000714:Anastomosis, Surgical / Q000379:methods*; D000818:Animals; D002983:Clinical Competence; D003082:Colectomy / Q000379:methods / Q000592:standards; D004285:Dogs; D005260:Female; D007420:Intestine, Large / Q000601:surgery*; D007421:Intestine, Small / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods* / Q000592:standards; D008954:Models, Biological; D017145:Models, Educational; D013552:Swine