Laparoscopic ultrasonography: A training model

J. I. Restrepo, L. Stocchi, Heidi Nelson, T. M. Young-Fadok, D. R. Larson, D. M. Ilstrup

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

PURPOSE: The purpose of this study was to develop a surgical training program and to test the accuracy of laparoscopic ultrasound in detecting injected lesions in pig livers. METHODS: Pig livers were divided into eight segments and injected with Surgilube® "malignant" and silicone "benign" lesions. All were examined by laparoscopic ultrasound followed by liver explantation to confirm results. First, a pilot study was conducted on six swine by injecting Surgilube® lesions and performing laparoscopic ultrasound through 3 different ports (left upper quadrant (I), umbilicus (II), and right lower quadrant (III) to determine per-segment accuracy and to optimize port placement. Second, blinded injection of Surgilube® and silicone implants was done on 18 pigs with laparoscopic ultrasound conducted through the two most accurate ports from the pilot study. This model was then tested during a resident training workshop. RESULTS: In the pilot study, per-lesion and per-segment sensitivity was 96 percent, with no difference among the three ports used. Ports I and II were chosen for the blinded study for their convenience in performing laparoscopic colectomy. In the blinded study, per-segment sensitivity, specificity, and accuracy were 97 percent, 94 percent, and 96 percent and 99 percent, 94 percent, and 97 percent for ports I and II, respectively. At the conclusion of a pilot workshop, trainee per-segment sensitivity, specificity, and accuracy were 60 percent, 80 percent, and 70 percent, respectively. The major difficulty, was differentiating benign from malignant lesions. CONCLUSIONS: A useful liver laparoscopic ultrasound training model for surgeons was developed with good preliminary results. It is anticipated that further training will enhance laparoscopic ultrasound accuracy rates before application of this modality in humans.

Original languageEnglish (US)
Pages (from-to)632-637
Number of pages6
JournalDiseases of the Colon and Rectum
Volume44
Issue number5
StatePublished - 2001

Fingerprint

Ultrasonography
Swine
Liver
Silicones
Education
Umbilicus
Sensitivity and Specificity
Colectomy
Injections
phenylmercury borate

Keywords

  • Artificial lesions
  • Laparoscopic ultrasound
  • Pigs
  • Training model

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Restrepo, J. I., Stocchi, L., Nelson, H., Young-Fadok, T. M., Larson, D. R., & Ilstrup, D. M. (2001). Laparoscopic ultrasonography: A training model. Diseases of the Colon and Rectum, 44(5), 632-637.

Laparoscopic ultrasonography : A training model. / Restrepo, J. I.; Stocchi, L.; Nelson, Heidi; Young-Fadok, T. M.; Larson, D. R.; Ilstrup, D. M.

In: Diseases of the Colon and Rectum, Vol. 44, No. 5, 2001, p. 632-637.

Research output: Contribution to journalArticle

Restrepo, JI, Stocchi, L, Nelson, H, Young-Fadok, TM, Larson, DR & Ilstrup, DM 2001, 'Laparoscopic ultrasonography: A training model', Diseases of the Colon and Rectum, vol. 44, no. 5, pp. 632-637.
Restrepo JI, Stocchi L, Nelson H, Young-Fadok TM, Larson DR, Ilstrup DM. Laparoscopic ultrasonography: A training model. Diseases of the Colon and Rectum. 2001;44(5):632-637.
Restrepo, J. I. ; Stocchi, L. ; Nelson, Heidi ; Young-Fadok, T. M. ; Larson, D. R. ; Ilstrup, D. M. / Laparoscopic ultrasonography : A training model. In: Diseases of the Colon and Rectum. 2001 ; Vol. 44, No. 5. pp. 632-637.
@article{5687baa4f1e34c128a0be7f152a2acfa,
title = "Laparoscopic ultrasonography: A training model",
abstract = "PURPOSE: The purpose of this study was to develop a surgical training program and to test the accuracy of laparoscopic ultrasound in detecting injected lesions in pig livers. METHODS: Pig livers were divided into eight segments and injected with Surgilube{\circledR} {"}malignant{"} and silicone {"}benign{"} lesions. All were examined by laparoscopic ultrasound followed by liver explantation to confirm results. First, a pilot study was conducted on six swine by injecting Surgilube{\circledR} lesions and performing laparoscopic ultrasound through 3 different ports (left upper quadrant (I), umbilicus (II), and right lower quadrant (III) to determine per-segment accuracy and to optimize port placement. Second, blinded injection of Surgilube{\circledR} and silicone implants was done on 18 pigs with laparoscopic ultrasound conducted through the two most accurate ports from the pilot study. This model was then tested during a resident training workshop. RESULTS: In the pilot study, per-lesion and per-segment sensitivity was 96 percent, with no difference among the three ports used. Ports I and II were chosen for the blinded study for their convenience in performing laparoscopic colectomy. In the blinded study, per-segment sensitivity, specificity, and accuracy were 97 percent, 94 percent, and 96 percent and 99 percent, 94 percent, and 97 percent for ports I and II, respectively. At the conclusion of a pilot workshop, trainee per-segment sensitivity, specificity, and accuracy were 60 percent, 80 percent, and 70 percent, respectively. The major difficulty, was differentiating benign from malignant lesions. CONCLUSIONS: A useful liver laparoscopic ultrasound training model for surgeons was developed with good preliminary results. It is anticipated that further training will enhance laparoscopic ultrasound accuracy rates before application of this modality in humans.",
keywords = "Artificial lesions, Laparoscopic ultrasound, Pigs, Training model",
author = "Restrepo, {J. I.} and L. Stocchi and Heidi Nelson and Young-Fadok, {T. M.} and Larson, {D. R.} and Ilstrup, {D. M.}",
year = "2001",
language = "English (US)",
volume = "44",
pages = "632--637",
journal = "Diseases of the Colon and Rectum",
issn = "0012-3706",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Laparoscopic ultrasonography

T2 - A training model

AU - Restrepo, J. I.

AU - Stocchi, L.

AU - Nelson, Heidi

AU - Young-Fadok, T. M.

AU - Larson, D. R.

AU - Ilstrup, D. M.

PY - 2001

Y1 - 2001

N2 - PURPOSE: The purpose of this study was to develop a surgical training program and to test the accuracy of laparoscopic ultrasound in detecting injected lesions in pig livers. METHODS: Pig livers were divided into eight segments and injected with Surgilube® "malignant" and silicone "benign" lesions. All were examined by laparoscopic ultrasound followed by liver explantation to confirm results. First, a pilot study was conducted on six swine by injecting Surgilube® lesions and performing laparoscopic ultrasound through 3 different ports (left upper quadrant (I), umbilicus (II), and right lower quadrant (III) to determine per-segment accuracy and to optimize port placement. Second, blinded injection of Surgilube® and silicone implants was done on 18 pigs with laparoscopic ultrasound conducted through the two most accurate ports from the pilot study. This model was then tested during a resident training workshop. RESULTS: In the pilot study, per-lesion and per-segment sensitivity was 96 percent, with no difference among the three ports used. Ports I and II were chosen for the blinded study for their convenience in performing laparoscopic colectomy. In the blinded study, per-segment sensitivity, specificity, and accuracy were 97 percent, 94 percent, and 96 percent and 99 percent, 94 percent, and 97 percent for ports I and II, respectively. At the conclusion of a pilot workshop, trainee per-segment sensitivity, specificity, and accuracy were 60 percent, 80 percent, and 70 percent, respectively. The major difficulty, was differentiating benign from malignant lesions. CONCLUSIONS: A useful liver laparoscopic ultrasound training model for surgeons was developed with good preliminary results. It is anticipated that further training will enhance laparoscopic ultrasound accuracy rates before application of this modality in humans.

AB - PURPOSE: The purpose of this study was to develop a surgical training program and to test the accuracy of laparoscopic ultrasound in detecting injected lesions in pig livers. METHODS: Pig livers were divided into eight segments and injected with Surgilube® "malignant" and silicone "benign" lesions. All were examined by laparoscopic ultrasound followed by liver explantation to confirm results. First, a pilot study was conducted on six swine by injecting Surgilube® lesions and performing laparoscopic ultrasound through 3 different ports (left upper quadrant (I), umbilicus (II), and right lower quadrant (III) to determine per-segment accuracy and to optimize port placement. Second, blinded injection of Surgilube® and silicone implants was done on 18 pigs with laparoscopic ultrasound conducted through the two most accurate ports from the pilot study. This model was then tested during a resident training workshop. RESULTS: In the pilot study, per-lesion and per-segment sensitivity was 96 percent, with no difference among the three ports used. Ports I and II were chosen for the blinded study for their convenience in performing laparoscopic colectomy. In the blinded study, per-segment sensitivity, specificity, and accuracy were 97 percent, 94 percent, and 96 percent and 99 percent, 94 percent, and 97 percent for ports I and II, respectively. At the conclusion of a pilot workshop, trainee per-segment sensitivity, specificity, and accuracy were 60 percent, 80 percent, and 70 percent, respectively. The major difficulty, was differentiating benign from malignant lesions. CONCLUSIONS: A useful liver laparoscopic ultrasound training model for surgeons was developed with good preliminary results. It is anticipated that further training will enhance laparoscopic ultrasound accuracy rates before application of this modality in humans.

KW - Artificial lesions

KW - Laparoscopic ultrasound

KW - Pigs

KW - Training model

UR - http://www.scopus.com/inward/record.url?scp=0035005305&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035005305&partnerID=8YFLogxK

M3 - Article

C2 - 11357020

AN - SCOPUS:0035005305

VL - 44

SP - 632

EP - 637

JO - Diseases of the Colon and Rectum

JF - Diseases of the Colon and Rectum

SN - 0012-3706

IS - 5

ER -