Cadaverを用いた腹腔鏡下手術トレーニングの経験と今後への課題

抄録

Objective: This study aimed to report the experiences and problems associated with surgical training using a cadaver.

Materials and Methods: A surgical technique training was held in our department using a cadaver, which was embalmed using Thiel's method once a year since 2014. In consideration of the widespread introduction of laparoscopic surgery, we set up the first laparoscopic booth in addition to laparotomy training in 2016. The Thiel's method was used to treat the corpse.

Result: The Thiel's method, which preserves the texture of the corpse as close to the living body as possible compared with the conventional embalming method, leads to good operability. Manual operation with radical hysterectomy and exteriorization of the blood vessels/nerves in the deep pelvis could be performed with an almost similar protocol as in the actual operation. However, as bleeding did not occur, tension reduced and the procedure was not performed with as much care and precision. During laparoscopic training, in addition to the confirmation of the anatomy, performing the surgical procedure becomes easier. Thus, among the doctors who perform laparoscopic radical hysterectomy, the timing to change from manual operation to professional laparoscopy is difficult. Due to the limitation in the number of donations and time constraints, setting goals according to the experience of the laparoscopic surgeon with malignant tumor surgeries and to devise measures such as changing of operators for each technique should be considered.

Conclusion: Laparoscopic training using a cadaver treated with Thiel's method was thought to be useful for practical training and anatomical learning.