Silicone-based composites as surgical breast models for oncoplasty training

Surgeons-in-training necessitate practice to improve their skill sets and the shift towards simulation-based trainings enables trainees to learn at their own pace and experience custom-based cases rather than responding to the immediate needs of the patients. Oncoplasty for breast cancer encompasses tumor removal and subsequent breast reconstruction; and there are several oncoplastic techniques to master for proper treatment of the patients. For training purposes, closest media to reality, fresh cadavers, are hard to obtain due to their price and/or unavailability. There is a need for a sustainable, reliable, and affordable platform to diffuse simulation-based trainings to medical curricula and provide trainings even in resource-limited settings. Silicone-based composite models can be designed and manufactured to fulfil the necessities of breast surgery such as precise incision, epidermal undermining, suturing, and resisting suture tension after excision of a considerable mass. We have shown the performance of such a stand-alone breast model for two oncoplastic techniques, “Batwing Mammoplasty” and “Modified Inferior Flap Rezai”. This model can be used in settings where it is difficult and/or expensive to find fresh cadavers. This cost-effective and practical solution also eliminates the need for chemical/cold storage and risk of infections/molding, thus making it a preferable tool for teaching hospitals and also for individual practice. In addition, the model is suitable to be used in self-diagnosis trainings, as well as a communication platform between surgeons and patients

Left-sided thoracoscopy in the prone position for surgery of distal esophageal benign pathologies

Exposure of the distal esophagus can be achieved by a wide variety of surgical approaches. The standard procedure is mostly by laparoscopy. In cases where laparoscopy is relatively contraindicated, thoracoscopy is preferred. In this case, exposure of the distal esophagus from the aorta, heart and lung is technically challenging using thoracoscopy in the right lateral decubitus position. Surgery in the prone position for esophageal cancer has been successfully described in previous literature. We present our experience with left-sided thoracoscopy in the prone position in three patients with benign distal esophageal pathologies. This approach provided a much better exposure of the distal esophagus and enabled a successful surgery to be done in all patients with less manipulation of the lung