Experimental model as training tool in endoscopic axillary dissection.
Endoscopic axillary lymphatic dissection is a viable surgical option, but has not been taken with great enthusiasm; several factors have accounted for this, including the lack of an effective experimental model to acquire skills and abilities. The aim of this study was to develop a training tool for endoscopic axillary dissection and to evaluate its applicability in a porcine model. Twenty endoscopic dissections of the axilla were performed in ten female pigs of four to six months by a single surgeon with blunt dissection and CO(2). A surgical workflow was divided into temporal operative phases. Time necessary to perform this action was compared throughout the study. The mean dissection time was 26 +/- 7 minutes. The axillary content was separated from the other anatomical elements under complete visualization (85%). Intraoperative complications occurred in two dissections (10%). Residual fibrofatty tissue was removed from the axilla in three dissections. This data defined a pig model for commencement of training in endoscopic axillary dissection in the laboratory. Bringing these core elements together led to the development of a model for acquiring advanced laparoscopic skills, which may be applicable to other endoscopic axillary procedures.
Endoscopic Surgery Unit, Service of Surgery, 2, Caracas University Hospital, University City, Caracas, Venezuela. maruaponte@gmail.com
María Eugenia
ME
Aponte-Rueda
Ramón A
RA
Saade-Cárdenas
Salvador
S
Navarrete-Aulestia
D000818:Animals; D001365:Axilla; D002983:Clinical Competence; D004195:Disease Models, Animal; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008197:Lymph Node Excision / Q000379:methods*; D013552:Swine; D013997:Time Factors; D057188:Workflow