Surgery is a skill, and like any other skill people improve with practice . This should not be surprising to anyone - but what is shocking is the lack of good training models. For example, let us consider laparoscopic cholecystectomy (gall bladder removal), one of the most common laproscopic procedures. The main training methods available for this surgery consist of practicing on the organs of dead pigs or using computer-based simulations. Unfortunately, there are problems with both of these methods. The body of a dead pig, for instance, responds quite differently than that of a live patient. Computer based simulations are even worse, as they cannot truly mimic the haptic feedback surgeons get when performing a real surgery. Indeed, a recent paper reviewing these practice techniques concluded:
"For trainees who are proficient in basic laparoscopic skills, the long-term advantage of additional procedural training, especially on a virtual but also on the conventional organ training model, remains to be proven."
Due to the limitations of current practice models, residents often learn key skills on the job, typically under the supervision of an experienced surgeon. When inexperienced surgeons perform laproscopic procedures, their patients can suffer higher rates of complications, longer surgery times, and longer recovery times . Indeed, early research on laparoscopic cholecystectomy has demonstrated that:
"90% of the injuries occurred within the first 30 cases performed by an individual surgeon."
This statistic indicates the dire need for improved training methods that allow surgeons to improve their skill before operating on patients.
It is important to stress that this is not the fault of the medical schools, hospitals, or the residents, who are doing everything they can to make sure every operation is successful. Instead, the problem is the lack of good training tools that properly emulate real life surgery. By giving residents life-like training models to practice on, training programs could ensure the residents are proficient before operating on patients. This has the potential to reduce complication rates, save lives, and save hospitals up to $53 million per year by reducing operation times.
These observations motivate us here at Lazarus 3D to create surgery models, like our laproscopic cholecystectomy model, that improve the healthcare system and give residents the tools they need to be confident and successful during their first live operation. Ongoing research will help us determine the effectiveness of this new generation of life-like, 3D printed models built off of actual patient data.
Thank you for reading my first journal post, and please let me know what you think about the topic in the comments!
~Dr. Jacques Zaneveld
: Moore, M.J. and C.L. Bennett, The learning curve for laparoscopic cholecystectomy. The Southern Surgeons Club. Am J Surg, 1995. 170(1): p. 55-9.
: Van Bruwaene, S., et al., Porcine cadaver organ or virtual-reality simulation training for laparoscopic cholecystectomy: a randomized, controlled trial. J Surg Educ, 2015. 72(3): p. 483-90.
: Krell, R.W., et al., Effects of resident involvement on complication rates after laparoscopic gastric bypass. J Am Coll Surg, 2014. 218(2): p. 253-60.
: Bridges, M. and D.L. Diamond, The financial impact of teaching surgical residents in the operating room. Am J Surg, 1999. 177(1): p. 28-32.
"I believe your 3D Model of my kidney played a critical role in the success of my surgery. It enabled the very skilled Dr. Link to do a complex partial nephrectomy, which preserved the vast majority of my kidney function. Since I already had multiple myeloma, my renal function was (and is) essential to my continued well being."
~Mr. Charles Lewis, a patient whose kidney and tumor we modeled
"This Is the Best Model for Partial nephrectomy I have ever seen"
~Dr. Richard Link, director of the the BCM Division of Endourology and Minimally Invasive Surgery BCM