中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2010年
6期
376-378
,共3页
居正华%应敏刚%朱庆国%艾星%王超%张国玺%史涛坪%王保军%张旭%刘文居
居正華%應敏剛%硃慶國%艾星%王超%張國璽%史濤坪%王保軍%張旭%劉文居
거정화%응민강%주경국%애성%왕초%장국새%사도평%왕보군%장욱%류문거
腹腔镜%吻合术%外科%动物模型
腹腔鏡%吻閤術%外科%動物模型
복강경%문합술%외과%동물모형
Laparoscopes%Anastomosis,surgical%Animal model
目的 建立模拟膀胱尿道单针连续吻合法训练的动物模型.方法 体质量30 kg左右的巴马小型猪20只,速眠新10 mg/kg诱导麻醉,3.5%戊巴比妥钠0.25 g/kg术中维持.取仰卧位经脐点穿刺导入CO2制备气腹,放置3个工作套管.游离出尿道蒂,取末端小肠作为代膀胱.按照腹腔镜下膀胱尿道单针连续吻合法步骤完成吻合.6名具有腹腔镜体外模拟训练经验的学员参加培训,根据手术时间评估学员的学习曲线.结果 6名学员在该模型上均成功完成腹腔镜下膀胱尿道单针连续吻合法的各项操作技术.每只模型猪可行3次手术,学员平均接受10次膀胱尿道单针连续吻合法训练,平均手术时间第1次(55.5±10.4)min,第10次(22.4±4.8)min,2次手术时间比较差异有统计学意义(P＜0.01).结论 小猪模型末端小肠替代膀胱,反复利用游离尿道蒂可提供多次训练机会,能够使学员尽快掌握腹腔镜下膀胱尿道单针连续吻合法的操作技术.
目的 建立模擬膀胱尿道單針連續吻閤法訓練的動物模型.方法 體質量30 kg左右的巴馬小型豬20隻,速眠新10 mg/kg誘導痳醉,3.5%戊巴比妥鈉0.25 g/kg術中維持.取仰臥位經臍點穿刺導入CO2製備氣腹,放置3箇工作套管.遊離齣尿道蒂,取末耑小腸作為代膀胱.按照腹腔鏡下膀胱尿道單針連續吻閤法步驟完成吻閤.6名具有腹腔鏡體外模擬訓練經驗的學員參加培訓,根據手術時間評估學員的學習麯線.結果 6名學員在該模型上均成功完成腹腔鏡下膀胱尿道單針連續吻閤法的各項操作技術.每隻模型豬可行3次手術,學員平均接受10次膀胱尿道單針連續吻閤法訓練,平均手術時間第1次(55.5±10.4)min,第10次(22.4±4.8)min,2次手術時間比較差異有統計學意義(P＜0.01).結論 小豬模型末耑小腸替代膀胱,反複利用遊離尿道蒂可提供多次訓練機會,能夠使學員儘快掌握腹腔鏡下膀胱尿道單針連續吻閤法的操作技術.
목적 건립모의방광뇨도단침련속문합법훈련적동물모형.방법 체질량30 kg좌우적파마소형저20지,속면신10 mg/kg유도마취,3.5%무파비타납0.25 g/kg술중유지.취앙와위경제점천자도입CO2제비기복,방치3개공작투관.유리출뇨도체,취말단소장작위대방광.안조복강경하방광뇨도단침련속문합법보취완성문합.6명구유복강경체외모의훈련경험적학원삼가배훈,근거수술시간평고학원적학습곡선.결과 6명학원재해모형상균성공완성복강경하방광뇨도단침련속문합법적각항조작기술.매지모형저가행3차수술,학원평균접수10차방광뇨도단침련속문합법훈련,평균수술시간제1차(55.5±10.4)min,제10차(22.4±4.8)min,2차수술시간비교차이유통계학의의(P＜0.01).결론 소저모형말단소장체대방광,반복이용유리뇨도체가제공다차훈련궤회,능구사학원진쾌장악복강경하방광뇨도단침련속문합법적조작기술.
Objective To develop and evaluate a porcine model for training the single needle running suture method of laparoscopie urethrovesical anastomosis(LUA). Methods Twenty minipigs with mean weight of 30kg were general anaesthetized with Sumianxin solution 0. 1 ml/kg intramuscularly. Pneumoperitoneum was created by insufflation of carbon dioxide by a veress needle inserted through the umbilicus. One 10mm port and two 5mm ports were positioned after the establishment of pneumoperitoneum. The intestine was used as "bladder". The procedures were completed with the single needle running suture method of laparoscopic urethrovesical anastomosis. Six trainees performed the LUA procedure based on the models during a laparoscopic training course, following the technique used in the operation room. The learning curve was analyzed by operative time. Results The porcine model for laparoscopic training was established successfully and 3 LUAs could be performed on each pig. Each trainee performed 10 LUAs based on the models during the training course of laparoscopic urology. The operative time declined from (55.3±10. 4)min initially to (22.4±4.8)min (P＜0. 01) after the training course. At the end of training, all trainees could accomplish a watertight LUR procedure on the model. Conclusions The establishment of the training model is feasible. The trainees could acquire the skills necessary to perform LUA in vivo based on this model. The model provides a platform for training the basic techniques of LUA procedures.
