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目的:介绍腹腔镜肾部分切除术的多模培训模式,包括腹腔镜模拟器、动物模型和手术培训三部分,并评价其安全性、可行性和有效性。方法:邀请5名具有初步腹腔镜基本操作技术或没有腹腔镜手术经验的住院医师参与培训,在腹腔镜模拟器、小型猪模型和人体上进行肾部分切除术的模拟训练,收集培训过程中学员完成训练的手术时间,手术数量和围手术期数据并进行评价。结果:5位学员均成功接受所有培训,接受腹腔镜模拟器、小型猪动物模型训练,并最终独立完成4~6例肾部分切除术。所有患者均未中转开放手术,无输血及死亡病例发生,平均热缺血时间分别为29.8、30.8、29.7、32.3、30.0 min,平均手术时间分别为109.2、104.8、115.7、112.8、112.6min。5位学员独立完成手术的手术时间、失血量、术后住院时间和围手术期并发症均差异无统计学意义。结论:该多模培训模式安全可行,效果良好,适合于没有腹腔镜经验和肾部分切除术经验的学员进行学习培训。
OBJECTIVE: To introduce the multimodal training mode of laparoscopic partial nephrectomy, including laparoscopic simulator, animal model and surgical training, and to evaluate its safety, feasibility and effectiveness. Methods: Five residents with basic or no laparoscopic surgery were invited to participate in the training. The laparoscopic simulator, miniature pig model and human body were used to perform partial nephrectomy training. During the training, trainees The time of the operation, the number of operations and the perioperative data were completed and evaluated. Results: All the 5 trainees successfully received all the trainings, received laparoscopic simulator and miniature pig animal model training, and eventually completed 4 to 6 cases of partial nephrectomy independently. All patients were not transferred to open surgery, no blood transfusion and deaths occurred, the average time of warm ischemia were 29.8,30.8,29.7,32.3,30.0 min, the average operative time was 109.2,104.8,115.7,112.8,112.6min. There was no significant difference in the operation time, blood loss, postoperative hospital stay and perioperative complications between the 5 trainees independently. Conclusion: The multimodal training model is safe and feasible with good results. It is suitable for the study and training of trainees who have no experience of laparoscopy and partial nephrectomy.