Design of a physical simulation model for laparoscopic and robotic total mesorectal excision (TME) surgery.
Keyhole or laparoscopic surgery is an important method to improve outcomes for patients in the treatment of bowel cancer it is also extremely difficult to learn. Currently there are no training models available to trainee bowel surgeons and they learn the procedure “on the job” on real patients under supervision. This research, led by Mr Danilo Miskovic, aims to produce a physical model prototype for use in training using artificial materials.
The model will be designed by experienced surgeons and engineers and will be based on 3D MRI images from patients with rectal cancer. Silicon and hydrogels will be used to simulate anatomical tissue properties and together, these elements will create a realistic model. In this study a limited number of models, of both genders, will be produced and tested on experienced and trainee surgeons at Leeds Teaching Hospitals. This will test the feasibility of the model and be the potential basis for future projects. Implementation of these models could directly improve surgical skill and therefore the patient’s chances of surviving bowel cancer.
References
“Trainee” evaluation of the English National Training Programme for laparoscopiccolorectal surgery.Wyles SM, Miskovic D, Kennedy RH, Hanna GB, Coleman MG. Colorectal Dis. 2012. 14(6): 352-7
Observational clinical human reliability analysis (OCHRA) for competency assesment in laparoscopic colorectal surgery at the specialist level. Miskovic D, ni M, Wyles SM, Parvaiz, Hanna GB. Surg Endosc. 2012. 26(3): 796-803
“Blowing up the barriers”: exploring and validating a new approach for simulation. Kassab E, Tun JK, Arora S, King D, Ahmed K, Miskovic D, Cope A, Vadhwana B, Bello F, Sevdalis N, Kneebone R. Ann Surg. 2011. 254(6): 1059-65
Self vs Expert Assessment of Technical and Non-Technical Skills in High Fidelity Simulation. Arora S, Miskovic D, Hull L, Moorthy K, Aggarwal R, Johannsson H, Gautama S, Kneebone R, Sevdalis N. Am J Surg. 2011. 202(4):500-6
Observational assessment of technical skills – A systematic review.Ahmed K, Miskovic D, Nagpal K, Athanasiou T, Hanna GB. Am J Surg. 2011 202(4): 469-480
Analysis of laboratory based Laparoscopic Colorectal surgery workshops within the English National Training Programme. Wyles SM, Miskovic D, Ni Z, Acheson AG, Maxwell-Armstrong C, Longman R, Cecil T, Coleman MG, Horgon AF, Hanna GB. Surg Endosc. 2011. 25(5): 1559-66
Development, validation and implementation of a monitoring tool for training in laparoscopic colorectal surgery in the English National Training Programme. Miskovic D, Wyles SM, Coleman MG, Hanna GB. Surg Endosc. 2011. 25:1136-1142
Simulation and Mentoring in Laparoscopic Colorectal Surgery as an illustration of training in tecnically advanced procedures. A systematic review. Miskovic D, Wyles SM, Ni M, Darzi AW, Hanna GB. Ann Surg, 2010. 252(6): 943-951
The impact of established skills in open experience on the proficiency gain process for laparoscopic surgery. Brown D, Miskovic D, Hanna GB. Surg Endosc. 2010; 24(6): 943-951