Preliminary results with a training program for thoracoscopic atrial fibrillation therapy.
BACKGROUND
Novel devices have been designed for the treatment of atrial fibrillation (AF) using minimally invasive approaches. This study aimed to determine the usefulness of a sheep model for training in cardiac surgical ablation using a minimally invasive approach in an experimental hands-on training course.


METHODS
After initial training using a laparoscopic pelvic trainer, 15 sheep were subjected to surgery by six thoracic surgeons attending a hands-on thoracoscopic course. Dissection to the posterior wall of the pulmonary veins was followed by insertion of a microwave device around both the caudal cava vein and the pulmonary veins. The complications were recorded, and the effectiveness of the surgery was evaluated by complete deployment of the microwave device. The animals were killed after completion of the procedure.


RESULTS
Isolation of the cava vein and the pulmonary veins and placement of the microwave probe were performed successfully for 10 animals using a complete thoracoscopic approach. Two animals died during the procedure. The main complications of the procedure were hemorrhage and difficulty isolating the blood vessels using a minimally invasive procedure. After the training period, the thoracoscopic surgical maneuvers were accurate and reliable.


CONCLUSIONS
The technical feasibility of performing safe and efficient thoracoscopic placement of a microwave device in a sheep model was demonstrated in this study, suggesting that the results of this study are a useful contribution to the development of an animal model for surgical training and experimental cardiac surgeries.
Sánchez-Margallo
Francisco M
FM
Department of Laparoscopic Surgery, Minimally Invasive Surgery Centre Jesús Usón, Carretera N-521, 10071, Caceres, Spain. msanchez@ccmijesususon.com
Díaz-Güemes
Idoia
I
Pérez
Francisco J
FJ
Sánchez
Miguel A
MA
Loscertales
Beatriz
B
Usón
Jesús
J
D000818:Animals; D001281:Atrial Fibrillation / Q000601:surgery*; D016063:Blood Loss, Surgical; D003972:Diathermy / Q000295:instrumentation / Q000379:methods; D004502:Education, Medical, Continuing; D005240:Feasibility Studies; D006801:Humans; D008872:Microwaves / Q000627:therapeutic use; D023421:Models, Animal; D011667:Pulmonary Veins / Q000601:surgery; D012756:Sheep / Q000601:surgery; D013045:Species Specificity; D013903:Thoracic Surgery / Q000193:education*; D013906:Thoracoscopy / Q000379:methods*; D014684:Venae Cavae / Q000601:surgery