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Guo C, Liu L, Zhang J, Zhao K, Li S. Revolutionizing thoracic surgery education: a bibliometric analysis of the past decade's literature. J Cardiothorac Surg 2024; 19:428. [PMID: 38987798 PMCID: PMC11234603 DOI: 10.1186/s13019-024-02947-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 06/29/2024] [Indexed: 07/12/2024] Open
Abstract
OBJECTIVES Thoracic surgery is a complex field requiring advanced technical skills and critical decision-making. Surgical education must evolve to equip trainees with proficiency in new techniques and technologies. METHODS This bibliometric analysis systematically reviewed 113 articles on thoracic surgery skills training published over the past decade, retrieved from databases including Web of Science. Publication trends, citation analysis, author and journal productivity, and keyword frequencies were evaluated. RESULTS The United States contributed the most publications, led by pioneering institutions. Simulation training progressed from basic to sophisticated modalities and virtual reality emerged with transformative potential. Minimally invasive techniques posed unique learning challenges requiring integrated curricula. CONCLUSION Ongoing investments in educational research and curriculum innovations are imperative to advance thoracic surgery training through multidisciplinary strategies. This study provides an evidentiary foundation to optimize training and address the complexities of modern thoracic surgery.
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Affiliation(s)
- Chao Guo
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Shuaifuyuan 1, Wangfujing Street, Dongcheng district, Beijing, P. R. China
| | - Lei Liu
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Shuaifuyuan 1, Wangfujing Street, Dongcheng district, Beijing, P. R. China
| | - Jiaqi Zhang
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Shuaifuyuan 1, Wangfujing Street, Dongcheng district, Beijing, P. R. China
| | - Ke Zhao
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Shuaifuyuan 1, Wangfujing Street, Dongcheng district, Beijing, P. R. China
| | - Shanqing Li
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Shuaifuyuan 1, Wangfujing Street, Dongcheng district, Beijing, P. R. China.
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Gamberini G, Maglio S, Mariani A, Mazzotta AD, Forgione A, Marescaux J, Melfi F, Tognarelli S, Menciassi A. Design and preliminary validation of a high-fidelity vascular simulator for robot-assisted manipulation. Sci Rep 2024; 14:4779. [PMID: 38413654 PMCID: PMC10899586 DOI: 10.1038/s41598-024-55351-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 02/21/2024] [Indexed: 02/29/2024] Open
Abstract
The number of robot-assisted minimally invasive surgeries is increasing annually, together with the need for dedicated and effective training. Surgeons need to learn how to address the novel control modalities of surgical instruments and the loss of haptic feedback, which is a common feature of most surgical robots. High-fidelity physical simulation has proved to be a valid training tool, and it might help in fulfilling these learning needs. In this regard, a high-fidelity sensorized simulator of vascular structures was designed, fabricated and preliminarily validated. The main objective of the simulator is to train novices in robotic surgery to correctly perform vascular resection procedures without applying excessive strain to tissues. The vessel simulator was integrated with soft strain sensors to quantify and objectively assess manipulation skills and to provide real-time feedback to the trainee during a training session. Additionally, a portable and user-friendly training task board was produced to replicate anatomical constraints. The simulator was characterized in terms of its mechanical properties, demonstrating its realism with respect to human tissues. Its face, content and construct validity, together with its usability, were assessed by implementing a training scenario with 13 clinicians, and the results were generally positive.
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Affiliation(s)
- Giulia Gamberini
- Health Science Interdisciplinary Center, Scuola Superiore Sant'Anna, Pisa, Italy.
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera (Pisa), Italy.
- The Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy.
| | - Sabina Maglio
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera (Pisa), Italy
- The Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Andrea Mariani
- Health Science Interdisciplinary Center, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Alessandro Dario Mazzotta
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera (Pisa), Italy
- The Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
- Department of Surgery, Madre Giuseppina Vannini Hospital, Istituto Figlie Di San Camillo, Rome, Italy
| | - Antonello Forgione
- IRCAD France, Institut de recherche contre les cancers de l'appareil digestif, Strabourg Cedex, France
| | - Jacques Marescaux
- IRCAD France, Institut de recherche contre les cancers de l'appareil digestif, Strabourg Cedex, France
| | | | - Selene Tognarelli
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera (Pisa), Italy
- The Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Arianna Menciassi
- Health Science Interdisciplinary Center, Scuola Superiore Sant'Anna, Pisa, Italy
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera (Pisa), Italy
- The Department of Excellence in Robotics & AI, Scuola Superiore Sant'Anna, Pisa, Italy
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Gower EW, Kello AB, Kollmann KHM, Merbs SL, Sisay A, Tadesse D, Alemayehu W, Pedlingham N, Dykstra RS, Johnson JE. The impact of incorporating surgical simulation into trichiasis surgery training on operative aspects of initial live-training surgeries. PLoS Negl Trop Dis 2023; 17:e0011125. [PMID: 37014903 PMCID: PMC10112793 DOI: 10.1371/journal.pntd.0011125] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 04/18/2023] [Accepted: 01/30/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND While surgical simulation is regularly used in surgical training in high-income country settings, it is uncommon in low- and middle-income countries, particularly for surgical training that primarily occurs in rural areas. We designed and evaluated a novel surgical simulator for improving trachomatous trichiasis (TT) surgery training, given that trichiasis is mostly found among the poorest individuals in rural areas. METHODOLOGY/PRINCIPAL FINDINGS TT surgery programs were invited to incorporate surgical simulation with a new, high fidelity, low-cost simulator into their training. Trainees completed standard TT-surgery training following World Health Organization guidelines. A subset of trainees received three hours of supplemental training with the simulator between classroom and live-surgery training. We recorded the time required to complete each surgery and the number of times the trainer intervened to correct surgical steps. Participants completed questionnaires regarding their perceptions. We also assessed trainer and trainee perceptions of surgical simulation training as part of trichiasis surgery training. 22 surgeons completed standard training and 26 completed standard training plus simulation. We observed 1,394 live-training surgeries. Average time to first live-training surgery completion was nearly 20% shorter the simulation versus the standard group (28.3 vs 34.4 minutes; p = 0.02). Trainers intervened significantly fewer times during initial live-training surgeries in the simulation group (2.7 vs. 4.8; p = 0.005). All trainers indicated the simulator significantly improved training by allowing trainees to practice safely and to identify problem areas before performing live-training surgeries. Trainees reported that simulation practice improved their confidence and skills prior to performing live-training surgeries. CONCLUSIONS A single high-fidelity surgical simulation session can significantly improve critical aspects of initial TT surgeries.
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Affiliation(s)
- Emily W. Gower
- Departments of Epidemiology and Ophthalmology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Amir B. Kello
- World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo
| | | | - Shannath L. Merbs
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | | | | | | | | | - Richard S. Dykstra
- Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
| | - James E. Johnson
- Wake Forest School of Medicine, Winston-Salem, North Carolina, United States of America
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Lin Y, Vervoort D, Thapa B, Sapkota R, Mitchell JD. Minimally Invasive Thoracic Surgery for Low- and Middle-Income Countries. Thorac Surg Clin 2022; 32:405-412. [PMID: 35961748 DOI: 10.1016/j.thorsurg.2022.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
The burden of respiratory and upper-gastrointestinal diseases especially affects low- and middle-income countries. Five billion people lack access to safe, timely, and affordable surgical care, including thoracic surgical care. Minimally invasive thoracic surgery (MITS) has been shown to reduce complications, shorten hospital lengths of stay, and minimize health care costs, thereby enabling patients to pay less out-of-pocket and/or limit time away from work and families. Experiences with MITS exist but are limited in low- and middle-income countries; professional societies, academic institutions, policymakers, and industry can facilitate scale-up of MITS by increasing financing, expanding surgical training, and optimizing surgical supply chains.
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Affiliation(s)
- Yihan Lin
- Division of Cardiothoracic Surgery, C-31012631 E. 17th Avenue, Aurora, CO 80045, USA
| | - Dominique Vervoort
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Bibhusal Thapa
- Thoracic Surgery Unit, Division of Surgery, Northern Health, Epping, Victoria, Australia
| | - Ranjan Sapkota
- Department of Cardio-Thoracic and Vascular Surgery, Manmohan Cardio-Thoracic Vascular and Transplant Center, Institute of Medicine, Kathmandu, Nepal
| | - John D Mitchell
- Division of Cardiothoracic Surgery, C-31012631 E. 17th Avenue, Aurora, CO 80045, USA.
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