While training involving dry boxes is relatively easier to perform with no constraint on where the training can be performed, it is only suitable for the training of basic laparoscopic skills such as suturing and handling of the instruments. In this seminar, our purpose was focused more on the training of advanced surgical skills, for which we felt that training using only the dry boxes was inadequate. While animal models play an important role in the field of surgical training, especially for training in advanced surgical procedures, factors such as the lack of an animal lab facility, need for an animal care facility, and the anaesthesia setup make it difficult for this type of training to be performed in any medical facility. These factors may have been limiting the development of animal lab for surgical training.
Our institution has been conducting small-scale training seminars using live porcine models for our residents for the past few years. With that experience, when we collaborated with the Reduced Port Surgery Forum to organise the large-scale hands-on seminar, we were able to determine the requirements for the anaesthesia of 10 porcine models. While a human cadaver solves the problem of anaesthesia, it is not always easy to secure the large required number of human cadavers for a seminar as seminars using human cadavers are not very common in Japan. Hence, we felt that the porcine cadaver model was our best option. Though at the time of the seminar there was a lack of literature with regard to the use of a fresh porcine cadaver model for surgical training, we felt that it would meet our primary goal of giving the participants the opportunity to try various access ports, platforms, and devices. Bordeianou et al. (2014) recently reported the use of a fresh cadaver porcine model for training in the transanal endoscopic microsurgery (TEM) procedure. To our knowledge this is the first report of the use of a fresh cadaver porcine model for training in laparoscopic procedures. Using a fresh porcine cadaver model has its own limitations. Being an animal model, a difference in anatomy exists. In addition, as we do not use anaesthesia, there are no respiratory movements. It is also impossible to recreate bleeding as in real operations or in live animal models. However, compared to cadavers, fresh cadaver models do have some oozing from the blood vessels. Our training did not involve simulation of bleeding or haemostasis technique, but involved the adaptation and overcoming of the loss of angulation that comes with single port surgery, and the use and adaptation of different devices available to perform different steps in the surgeries performed with conventional laparoscopy. A fresh porcine cadaver model provides that platform without the need of anaesthesia or an animal care facility.
We feel that training seminars using fresh porcine cadaver models have huge potential as an important tool in surgical education. As there is no need for an animal care facility to take care of the animals before the seminar or an anaesthesia facility during the seminar, a seminar using fresh porcine cadaver models can be conducted at any institution. This can increase the number of surgeons who can participate in these sorts of seminars and also pave the way for simulator-based training to be included in surgical residencies or fellowship courses. 153554b96e