복강경하 요도방광 문합술 훈련을 위한 연습 모델 및 프로그램
A Model and a Program for Training Laparoscopic Urethrovesical Anastomosis
안규일, 이정원, 박종민, 배관식, 이동기, 전승현,
소속 상세정보
안규일 ( Ahn Kyu-IL )
경희대학교 의과대학 비뇨기과학교실
이정원 ( Yi Jeong-Won )
경희대학교 의과대학 비뇨기과학교실
박종민 ( Park Jong-Min )
경희대학교 의과대학 비뇨기과학교실
배관식 ( Bae Kwan-Sik )
경희대학교 의과대학 비뇨기과학교실
이동기 ( Lee Dong-Gi )
경희대학교 의과대학 비뇨기과학교실
전승현 ( Jeon Seung-Hyun )
경희대학교 의과대학 비뇨기과학교실
KMID : 0358320060470040407
Abstract
Purpose: A model and a program was developed for training surgeons in laparoscopic urethrovesical anastomosis in order to improve the laparoscopic suture technique for urologists with no previous experience.
Materials and Methods: The procedures were performed on a pelvic trainer using a videolaparoscopic unit. The program consisted of a simple suture, urethrovesical anastomosis with interrupted sutures, and urethrovesical anastomosis with continuous sutures. The trainees enrolled in this study were 5 residents from the urologic department who had little experiences in laparoscopic suturing. The trainees performed each procedure 10 times and the elapsed time was recorded. Univariate analysis of the general linear model was used to assess the significance of progression.
Results: In the first lesson of the simple suture, the mean elapsed time was 5.45±3.00 minutes(range 2.78-9.83minutes) and each trainee demonstrated a difference in the elapsed time for suturing. After the tenth lesson was complete, the mean elapsed time was 1.48±0.17 minutes(range 1.35- 1.70 minutes) and the time differences between each trainee decreased. In urethrovesical anastomosis with interrupted sutures, the mean elapsed time decreased from 24.07±3.97 minutes at the 1st lesson(range 16.13- 29.47 minutes) to 13.10±2.53 minutes(range 11.75-19.47 minutes) after 10 lessons. In urethrovesical anastomosis with continuous sutures, the mean time decreased from 39.61±3.60 minutes(range 34.41-45.71 minutes) after one lesson to 30.42±5.75 minutes(range 19.50-38.82 minutes) after 10 lessons. There were significant differences in the elapsed time up to the 2nd lesson compared with the 10th lesson in all procedures(p-value＜0.05).
Conclusions: The skills of the trainee can be improved by a model and a program for training laparoscopic urethrovesical anastomosis. In particular, urethrovesical anastomosis, in which many urologists find difficulty, may become more accessible using this model and program. (Korean J Urol 2006;47:407-411)
키워드
Laparoscopy;Surgical anastomosis;Training
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