Surgical Training for Transanal Total Mesorectal Excision in a Live Animal Model: A Preliminary Experience.

J Laparoendosc Adv Surg Tech A

Department of General Surgery, Fondazione Policlinico Universitario "A. Gemelli"-IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.

Published: August 2022

AI Article Synopsis

  • - The study assessed the feasibility and effectiveness of using female Danish Landrace pigs as an animal model for training in transanal total mesorectal excision (TaTME) under experienced surgical supervision in Italy.
  • - Participants received structured, step-by-step guidance throughout the procedure, with no significant anatomical damage or animal fatalities reported, highlighting the realism of the training due to similarities between pig and human tissue.
  • - While pig models help improve surgical skills and handle complications like bleeding, the absence of certain tissues means these animal laboratories should complement, rather than replace, cadaver labs in surgical training, while also being cost-effective.

Article Abstract

In this preliminary experience, the feasibility and effectiveness of surgical training with an animal model for transanal total mesorectal excision (TaTME) were evaluated. The training was conducted in two experimental animal laboratories in Italy authorized by the Italian Ministry of Health, using female Danish Landrace pigs under the supervision of surgeons with extensive experience in TaTME, animal laboratory training and cadaver laboratory training. The procedure was divided into separate steps, and all the participants were guided step-by-step throughout the entirety of the procedure. During all the editions of the animal laboratory, all the procedures were completed with no major damage to the anatomical structures or intraoperative death of the animals. Live animal tissue is very similar to human tissue, helping trainees improve their tactile feedback. The bleeding effect improved the value of the training and taught the participants how to address this complication. The lack of mesorectal tissue in pigs compared with humans was the main difference. Animal laboratories should not be considered alternatives to cadaver laboratories but as complementary training activities due to their effectiveness and lower costs. Surgical training in animal models for TaTME seems to be effective and could be an opportunity to improve training alongside the use of a cadaver laboratory and proctoring.

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Source
http://dx.doi.org/10.1089/lap.2021.0845DOI Listing

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