Usefulness of Animal Laboratory Training for Total Laryngectomy

Abstract

Although on-the-job training is widely used for training in surgical procedures, due consideration must be paid to medical safety and medical ethics. We conduct an animal laboratory training program using live pigs for the purpose of improving surgical techniques. Here, we investigated the usefulness of this system for total laryngectomy. The subjects were 56 surgeons who performed a total laryngectomy and self-evaluated after training. Eight evaluation factors were considered: identification of the hyoid bone, identification of the thyroid cartilage, identification and cutting of the pharyngeal contractile muscle, identification and cutting of the superior laryngeal nerve, intraoperative tracheostomy and replacement of the intubation tube, preservation of the pharyngeal mucosa and laryngectomy, pharyngeal suture, and creation of a permanent tracheostomy. A comparison was made between physicians with 10 years or less of experience after graduation and those with 11 or more years in practice. There were 39 trainees in the former group and 17 in the latter. Physicians with 11 or more years of experience scored higher in all items, with significant differences especially in the factors of superior laryngeal nerve, laryngectomy, pharyngeal suture, and permanent tracheostomy. Because a pig's larynx is similar to the human larynx, a laryngectomy can be performed in the same manner as with human surgery. Scoring enabled extraction of those factors that younger doctors are relatively less skilled at. We concluded that animal laboratory training offers effective guidance and can make a positive contribution to safer operations in human patients.