Impact of cadaver training for learning abdominal wall reconstruction: our early experience

PURPOSE

Assess the utility of a hands-on cadaver workshop for teaching abdominal wall reconstruction (AWR) using components separation technique.

METHODS

Over a year, from June 2022 to July 2023, 112 surgeons participated in seven training courses focused on the eTEP technique for inguinal and ventral hernias. The workshops covered theoretical learning sessions followed by hands-on training using frozen human cadavers. An online survey was used to know the influence of our workshop on the clinical practice of the attendees.

RESULTS

Out of 112 total participants, 70% (78) participants completed the survey. Among them, 58% (45) surgeons had over 10 years of experience. The workshop resulted in approximately 85% (66) of participants successfully adapting to eTEP. Confidence levels significantly increased for all steps of the technique after the workshop (p < 0.001, Rank-Biserial Correlation = -1.000). Participants expressed high satisfaction with the course.

CONCLUSION

The cadaver model training program was found to be effective in reducing the learning curve and being replicable. This suggests its potential for widespread implementation as an introductory training model for learning the anatomy of abdominal wall and adapting this for treating hernias requiring AWR.

Laparoscopic peritoneal dialysis catheter insertion: an oasis harnessed-experience and results at a tertiary care centre in India

BACKGROUND

Peritoneal dialysis is a life sustaining renal replacement therapy for patients with end stage renal disease. In comparison to hemodialysis it offers better mobility and independence to patients. A number of techniques including open, laparoscopic and fluoroscopy guided, and their modifications, have been described for intraperitoneal catheter insertion. We describe our technique and results of laparoscopic peritoneal dialysis (PD) catheter insertion at a tertiary care centre in India.

CASE SERIES

48 patients were referred from the department of nephrology at our centre for laparoscopic PD catheter insertion. A two port technique was used in 37 patients and three port technique was implemented in the rest for simultaneous adhesiolysis and/or omentectomy. A straight tip catheter was tunneled through the rectus muscle in all patients. Two patients had incisional hernia from a previous abdominal surgery which was repaired concomitantly with onlay meshplasty.

RESULTS

The operative time ranged between 20 and 35 min under general anaesthesia. Three patients were subjected to urgent start dialysis of which one patient developed peridrain leak as an early complication which was managed conservatively. All other patients were commenced on peritoneal dialysis two weeks after surgery. There was no other surgical site occurrence or episodes of peritonitis reported in a 6 month follow up period with the department of nephrology.

CONCLUSION

In the era of minimal access surgery, the laparoscopic approach is feasible for widespread and safe use for PD catheter insertion. The benefits of PD can thus be made available to patients at civil hospitals even with a basic laparoscopy setup.

A prospective study of head injury patterns in motorcycle riders wearing/not wearing helmets

INTRODUCTION

Road traffic accidents (RTA) are a major public health problem and one of the five leading causes of morbidity and mortality around the world. Use of two wheelers are growing rapidly especially inlow to middle income countries leading to an increase in RTA. 27% deaths related to accidents in India are among users of motorized two wheelers.

AIMS

To study the pattern of head injuries in motorcycle riders wearing/not wearinghelmets.

MATERIALS AND METHODS

The study is designed as a prospective observational study. Study groups shall be initially categorized based on use of helmets and will be studied in terms of clinical presentation on admission. Basic epidemiological information will be collected in every patient. Case record shall be done in two parts.1) clinical survey 2) radiological survey . Survey is designed as per ATLS guidelines of assessment of trauma patients.

RESULTS

Helmet wearers suffered significantly less head and traumatic brain injuries than the non-helmeted counterparts.

CONCLUSION

Helmets provide significant protection against the morbidity and mortality of Traumatic brain injury (TBI) as a result of road traffic accidents (RTA).