New training model using chickens intestine for pediatric intestinal anastomosis

Deivid Ramos Dos Santos, Faustino Chaves Calvo, Daniel Haber Feijó, Nayara Pontes de Araújo, Renan Kleber Costa Teixeira, Edson Yuzur Yasojima, Deivid Ramos Dos Santos, Faustino Chaves Calvo, Daniel Haber Feijó, Nayara Pontes de Araújo, Renan Kleber Costa Teixeira, Edson Yuzur Yasojima

Abstract

Purpose: To develop a new low-cost, easy-to-make and available training model using chickens' intestine for infant intestinal anastomosis.

Methods: Segments of chicken intestine were used to create an intestinal anastomosis simulator. We tried to perform an end-to-end, end-to-side and side-to-side anastomosis. Handsewn sutured anastomosis were performed in single layered with interrupted prolene 5-0 suture. The parameters analyzed were cost, intestine's diameter and length, anastomosis patency and flow-through and leakage amount.

Results: In all cases it was possible to make the anastomosis in double layered without difficulties, different from the usual ones. There was a positive patency at all anastomoses after the end of the procedure, with no need for reinterventions.

Conclusion: The new training model using chickens' intestine for infant intestinal anastomosis is low-cost, easy-to-make and easy available.

Conflict of interest statement

Conflict of interest: none

Figures

Figure 1. Main maker steps. A -…
Figure 1. Main maker steps. A - Chicken's intestine. B - Bowel fragments after wash. C - Model connected with infusion set. D - Initial patency test.
Figure 2. Diagram of testing apparatus.
Figure 2. Diagram of testing apparatus.
Figure 3. Finished end-to-end anastomosis.
Figure 3. Finished end-to-end anastomosis.

References

    1. Chen C. The art of bowel anastomosis. Scand J Surg. 2012;101(4):238–240. doi: 10.1177/145749691210100403.
    1. Erb L, Hyman NH, Osler T. Abnormal vital signs are common after bowel resection and do not predict anastomotic leak. J Am Coll Surg. 2014 Jun;218(6):1195–1199. doi: 10.1016/j.jamcollsurg.2013.12.059.
    1. Tevis SE, Carchman EH, Foley EF, Heise CP, Harms BA, Kennedy GD. Does anastomotic leak contribute to high failure-to-rescue rates? Ann Surg. 2016 Jun;263(6):1148–1151. doi: 10.1097/SLA.0000000000001409.
    1. Chadi SA, Fingerhut A, Berho M, DeMeester SR, Fleshman JW, Hyman NH, Margolin DA, Martz JE, McLemore EC, Molena D, Newman MI, Rafferty JF, Safar B, Senagore AJ, Zmora O, Wexner SD. Emerging trends in the etiology, prevention, and treatment of gastrointestinal anastomotic leakage. J Gastrointest Surg. 2016 Dec;20(12):2035–2051. doi: 10.1007/s11605-016-3255-3.
    1. Hintz GC, Alshehri A, Bell CM, Butterworth SA. Stapled versus hand-sewn pediatric intestinal anastomoses: a retrospective cohort study. J Pediatr Surg. 2018 May;53(5):959–963. doi: 10.1016/j.jpedsurg.2018.02.021.
    1. Narayanan SK, Cohen RC, Shun A. Technical tips and advancements in pediatric minimally invasive surgical training on porcine based simulations. Pediatr Surg Int. 2014 Jun;30(6):655–661. doi: 10.1007/s00383-014-3502-1.
    1. Najmaldin A. Skills training in pediatric minimal access surgery. J Pediatr Surg. 2007 Feb;42(2):284–289. doi: 10.1016/j.jpedsurg.2006.10.033.
    1. Patel EA, Aydın A, Desai A, Dasgupta P, Ahmed K. Current status of simulation-based training in pediatric surgery: a systematic review. J Pediatr Surg. 2018 Dec;pii doi: 10.1016/j.jpedsurg.2018.11.019. S0022-3468(18)30809-1.
    1. Fahy AS, Fok KH, Gavrilovic B, Farcas M, Carrillo B, Gerstle JT, Azzie G. Refinement in the analysis of motion within low-cost laparoscopic simulators of differing size: implications on assessing technical skills. J Pediatr Surg. 2018 Dec;53(12):2480–2487. doi: 10.1016/j.jpedsurg.2018.08.014.
    1. McClelland TJ, Ford K, Dagash H, Lander A, Lakhoo K. Low-fidelity paediatric surgical simulation: description of models in low-resource settings. World J Surg. 2019 Jan; doi: 10.1007/s00268-019-04921-3. [Epub ahead of print]
    1. Grahem HD, Teixeira RKC, Feijó DH, Yamaki VN, Valente AL, Feitosa DJS, Júnior, Dos Reis JMC, Barros RSM. Low-cost vascular anastomosis training: the surgeon goes to Market. J Vasc Bras. 2017 Jul;16(3):262–266. doi: 10.1590/1677-5449.000817.
    1. Barros RSM, Leal RA, Teixeira RKC, Yamaki VN, Feijó DH, Gouveia EHH, Valente AL, Feitosa-Junior Silva DJ, Carvalho LTF. Continuous versus interrupted suture technique in microvascular anastomosis in rats. Acta Cir Bras. 2017 Sep;32(9):691–696. doi: 10.1590/s0102-865020170090000001.
    1. Willis RE, Wiersch J, Adams AJ, Al Fayyadh MJ, Weber RA, Wang HT. Development and evaluation of a simulation model for microvascular anastomosis training. J Reconstr Microsurg. 2017 Sep;33(7):493–501. doi: 10.1055/s-0037-1602760.
    1. Han JJ, Patrick WL. See one-practice-do one-practice-teach one-practice: the importance of practicing outside of the operating room in surgical training. J Thorac Cardiovasc Surg. 2019 Feb;157(2):671–677. doi: 10.1016/j.jtcvs.2018.07.108.
    1. Risler Z, Magee MA, Mazza JM, Goodsell K, Au AK, Lewiss RE, Pugliese RS, Ku B. A Three-dimensional printed low-cost anterior shoulder dislocation model for ultrasound-guided injection training. Cureus. 2018 Nov 2;10(11):e3536. doi: 10.7759/cureus.3536.

Source: PubMed

3
購読する