Systematic review of the current status of cadaveric simulation for surgical training

Background: There is growing interest in and provision of cadaveric simulation courses for surgical trainees. This is being driven by the need to modernize and improve the efficiency of surgical training within the current challenging training climate. The objective of this systematic review is to describe and evaluate the evidence for cadaveric simulation in postgraduate surgical training. Methods: A PRISMA‐compliant systematic literature review of studies that prospectively evaluated a cadaveric simulation training intervention for surgical trainees was undertaken. All relevant databases and trial registries were searched to January 2019. Methodological rigour was assessed using the widely validated Medical Education Research Quality Index (MERSQI) tool. Results: A total of 51 studies were included, involving 2002 surgical trainees across 69 cadaveric training interventions. Of these, 22 assessed the impact of the cadaveric training intervention using only subjective measures, five measured impact by change in learner knowledge, and 23 used objective tools to assess change in learner behaviour after training. Only one study assessed patient outcome and demonstrated transfer of skill from the simulated environment to the workplace. Of the included studies, 67 per cent had weak methodology (MERSQI score less than 10·7). Conclusion: There is an abundance of relatively low‐quality evidence showing that cadaveric simulation induces short‐term skill acquisition as measured by objective means. There is currently a lack of evidence of skill retention, and of transfer of skills following training into the live operating theatre

Cadaveric simulation for improving surgical training in dermatology.

Simulation models are rapidly changing medical education, especially the training of dermatology residents. Various models are available, including cadaveric simulations. Our study evaluates the impact of a cadaveric simulation on the training of dermatology residents. Over a period of three years, cadaveric simulation was shown to increase the surgical knowledge of residents. Residents were more confident in their knowledge of surgical anatomy and also surgical skills. Cadaveric simulation may offer a positive impact on resident training in dermatology

Video-based assistance system for training in minimally invasive surgery

In this paper, the development of an assisting system for laparoscopic surgical training is presented. With this system, we expect to facilitate the training process at the first stages of training in laparoscopic surgery and to contribute to an objective evaluation of surgical skills. To achieve this, we propose the insertion of multimedia contents and outlines of work adapted to the level of experience of trainees and the detection of the movements of the laparoscopic instrument into the monitored image. A module to track the instrument is implemented focusing on the tip of the laparoscopic tool. This tracking method does not need the presence of artificial marks or special colours to distinguish the instruments. Similarly, the system has another method based on visual tracking to localize support multimedia content in a stable position of the field of vision. Therefore, this position of the support content is adapted to the movements of the camera or the working area. Experimental results are presented to show the feasibility of the proposed system for assisting in laparoscopic surgical training

Learning methodology in surgical training

This manuscript aimed to review the literature data related to the surgical training program. This review showed some of the requirements to perform effective surgical training were direct supervision, predetermined repetitions according to surgical skill complexity, valid simulator models, number of students per model. This manuscript discussed how the surgical program could achieve competence using a critical thinking framework, integrated curriculum based on the rationale behind simulation training program.Esse manuscrito tem como objetivo revisar dados da literatura relacionados ao treinamento cirúrgico para  alunos de graduação me medicina.  Essa revisão demostrou que  alguns  pré requesitos são necessários para se realizar treinamento cirúrgico de maneira eficaz: supervisão direta, repetições  pré-determinadas de acordo com a complexidade  da atividade a ser ensinada, modelos de simuladores válidos, número de alunos por modelo. Esse manuscrito também  discutiu como o programa cirúrgico pode levar a competência  pelo desenvolvimento do pensamento crítico e pela integração curricular baseado no racional da  utilização de um programa de treinamento por  simuladores

From "silent teachers" to models

For decades, embalmed cadavers have played an important role in teaching anatomy to the scientists and doctors of the future. Most anatomy departments use a traditional formaldehyde-based embalming method, but formalin embalming makes the bodies very rigid, which limits their usefulness for procedures other than dissection. A more recent embalming method developed by W. Thiel has allowed these "silent teachers" to take on a further role in applied anatomy research and teaching: to act as models for surgical training and medical research

PORTABLE CAMERA AIDED SIMULATOR (PORTCAS) FOR MINIMALLY INVASIVE SURGICAL TRAINING

The present disclosure is directed to a system and method for surgical training with low cost, reusable materials and a highly customizable virtual environment for skill-building. According to various embodiments, a surgical training tool is usable in conjunction with a support structure configured to at least partially constrain the tool movement. Meanwhile, the tool is tracked in real-time with off-tool detectors to generate a tool path driving a virtual rendering of the surgical training tool in an operative environment. The virtual rendering may be visually observable via a display device and may include a customizable and/or selectable operative environment with one or more structures that can be operated on by the virtual surgical training tool. By tracking the virtual tool interaction with the virtual structures, a task path may be established for documenting and/or objectively assessing the performance of one or more operative tasks

Employing Process Models for Surgical Training

The exponential rise in minimally invasive procedures throughout the last three decades shifted the focus from individual manual skills to complex engineering solutions. To streamline the delivery of these novel techniques, Surgical Process Models (SPMs) have been under development. SPMs provide the basis for machine learning algorithms to frame the surgical procedure and anchor themselves into the workflow. Process recording is an essential tool to create an accurate representation of the SPM. Process recording, continued with human expert evaluation have been used to assess operator skills and compare interventional approaches. In this paper, we present a web-based surgical process recording tool which is evaluated in a surgical training scenario. Our aim is to involve the trainees in process recording, therefore actively exploring the generic process model of laparoscopic cholecystectomy. Along with training we also use the process records to identify the most accurately represented time points of process transitions, therefore providing target events for future monitoring systems

Motion Tracking System in Surgical Training

Introduction: Simulation technology is evolving and becoming the focus of attention in surgical training. The development of this technology in assessing open surgical skills is far behind when compared to minimally invasive surgery (MIS) training. Surgical skills such as suturing and tying surgical knots are assessed by an observational tool. It is labour-intensive and time-consuming. Therefore, we explored the potential use of motion tracking system as a non-observational assessment tool for basic surgical skills

Improving Surgical Training Phantoms by Hyperrealism: Deep Unpaired Image-to-Image Translation from Real Surgeries

Current `dry lab' surgical phantom simulators are a valuable tool for surgeons which allows them to improve their dexterity and skill with surgical instruments. These phantoms mimic the haptic and shape of organs of interest, but lack a realistic visual appearance. In this work, we present an innovative application in which representations learned from real intraoperative endoscopic sequences are transferred to a surgical phantom scenario. The term hyperrealism is introduced in this field, which we regard as a novel subform of surgical augmented reality for approaches that involve real-time object transfigurations. For related tasks in the computer vision community, unpaired cycle-consistent Generative Adversarial Networks (GANs) have shown excellent results on still RGB images. Though, application of this approach to continuous video frames can result in flickering, which turned out to be especially prominent for this application. Therefore, we propose an extension of cycle-consistent GANs, named tempCycleGAN, to improve temporal consistency.The novel method is evaluated on captures of a silicone phantom for training endoscopic reconstructive mitral valve procedures. Synthesized videos show highly realistic results with regard to 1) replacement of the silicone appearance of the phantom valve by intraoperative tissue texture, while 2) explicitly keeping crucial features in the scene, such as instruments, sutures and prostheses. Compared to the original CycleGAN approach, tempCycleGAN efficiently removes flickering between frames. The overall approach is expected to change the future design of surgical training simulators since the generated sequences clearly demonstrate the feasibility to enable a considerably more realistic training experience for minimally-invasive procedures.Comment: 8 pages, accepted at MICCAI 2018, supplemental material at https://youtu.be/qugAYpK-Z4

Impact of a global pandemic on surgical education and training- review, response, and reflection

The catastrophic effects of the coronavirus disease-2019 global pandemic have revolutionised human society. The unprecedented impact on surgical training needs to be analysed in detail to achieve an understanding of how to deal with similar situations arising in the foreseeable future. The challenges faced by the surgical community initiated with the suspension of clinical activities and elective practice, and included the lack of appropriate personal protective equipment, and the self-isolation of trainees and reassignment to coronavirus patient-care regions. Together, all these elements had deleterious effects on the psychological health of the professionals. Surgical training irrespective of specialty is equally affected globally by the pandemic. However, the global crisis inadvertently has led to a few constructive adaptations in healthcare systems, including the development of tele-clinics, virtual academic sessions and conferences, and increased usage of simulation. The current review article was planned to highlight the impact of corona virus disease on surgical training and institutions\u27 response to the situation in order to continue surgical training, and lessons learnt from the pandemic