A portable simulator helps surgeons hone skills outside of the OR.
Video-Assisted Thoracoscopic Surgery (VATS) offers a minimally-invasive approach to lung resection that studies show offers less pain, lower risk of infection, and shorter length of hospital stay compared to traditional thoracotomy1. Yet, today less than half of lung resections utilize a VATS approach2.
One reason is that VATS is a complex procedure that requires a significant amount of training. This training can be expensive and infrequent, and not all surgeons have access.
To address the problem, ETHICON collaborated with Tomaž Stupnik, M.D., PhD from University Medical Centre Ljubljana in Slovenia, to develop a transportable surgical simulator and structured curriculum to help both trainees and surgeons hone their core VATS skills.
“Training of core VATS skills outside of the operating room can help surgeons gain competency in a safe, efficient manner,” said Dr. Stupnik.
To complement the simulator, the Johnson & Johnson Institute professional education team in Europe designed and developed a low-cost, 30-degree thoracoscopic training camera which can be powered via a USB port. This enables the simulator to be run via a standard laptop rather than with expensive hospital equipment
Simulating the OR Experience
The ETHICON Stupnik VATS Simulator features an anatomically accurate thorax with interchangeable lung inserts. Each exercise addresses a core VATS skill, such as lung manipulation, tissue dissection with energy devices, wedge resection with endoscopic staplers, and dissection and transection of pulmonary vessels.
In partnership with the global thoracic surgeon community, ETHICON, through the Johnson & Johnson Institute, has been able to deliver the training to more than 2,500 surgeons. In addition, leading societies in Europe have incorporated the program into their training courses and pathways.
“Through continued collaboration, we hope to bring the benefits of this education and training to more surgeons, so together we can improve care for patients.” said James Kennedy, Ethicon Group Professional Education Manager, EMEA.
What surgeon leaders say about the Ethicon Stupnik Simulator Program:
“When I was training, simulation was not part of the official program. You learned on patients under the guidance of a mentor. But today, we should be able to do exercises on a simulator to gain basic skills, such as movement of instrument or camera. This way we can develop the basic skills before moving to the patient and that will only add to the safety of the procedure.”
-Prof. Hasan F. Batirel, M.D., Ph.D.
Marmara University Faculty of Medicine, Department of Thoracic Surgery, Instanbul
Education Director for the European Society of Thoracic Surgeons
“When I look back through my career, I practiced on patients, under a mentor, and gradually took over the procedure. Today, early engagement with simulation can increase the speed of getting skills, such as hand/eye coordination, in place so that you can bring a candidate up to par sooner and proceed with real dissection in the OR with more confidence."
-Prof. Peter Licht, M.D., Ph.D. Odense University Hospital, Department of Cardiothoracic Surgery, Denmark
Current president of European Association of Cardio-Thoracic Surgery
"One of the important elements of simulation is not just about learning the steps of surgical procedures but avoiding complications in real life. Prior experience with a simulator, enhances our knowledge on spatial anatomy of the lung hilum and offers confidence to progress with real life surgery.”
-Mr. Kostas Papagiannopoulos, M.D.
Consultant Thoracic Surgeon, Senior Honorary Lecturer, St. James’s University Hospital, Leeds, UK
Past president and Treasurer of European Society of Thoracic Surgeons
1. Cheng D et al. Video-Assisted Thoracic Surgery in Lung Cancer Resection: A Meta-Analysis and Systematic Review of Controlled Trials. Innovations 2007;2:261-92.
2. Blasberg J et al. Video-Assisted Thoracoscopic Lobectomy for Lung Cancer: Current Practice Patterns. Ann Thorac Surg 2016;102:1854–62
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