Experimental model as training tool in endoscopic axillary dissection

Minim Invasive Ther Allied Technol. 2010 Apr;19(2):61-8. doi: 10.3109/13645701003642776.

Abstract

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.

MeSH terms

  • Animals
  • Axilla
  • Clinical Competence*
  • Disease Models, Animal
  • Endoscopy / methods*
  • Female
  • Humans
  • Intraoperative Complications
  • Lymph Node Excision / methods*
  • Swine
  • Time Factors
  • Workflow