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ウエムラ シユウイチロウ
Uemura Shiyuuichirou
植村 修一郎 所属 医学部 医学科（東京女子医科大学病院） 職種 助教 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読なし |
| 表題 | Laparoscopic left hepatectomy in a goat as a training model for laparoscopic anatomic liver resection: results of training courses with a total of 70 goats |
| 掲載誌名 | 正式名：Surgical endoscopy 略 称：Surg Endosc ISSNコード：14322218/09302794 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 37(5),pp.3634-3641 |
| 著者・共著者 | KAWAMOTO Yusuke, HONDA Goro, OME Yusuke, MATSUNAGA Yutaro, UEMURA Shuichiro, YOSHIDA Naoki, KOTERA Yoshihito, ARIIZUMI Shunichi |
| 発行年月 | 2023/05 |
| 概要 | BACKGROUND:To create a suitable animal model for the training of laparoscopic anatomic liver resection, we performed left hepatectomy using a goat and found its suitability. We have since started using goats for wet-lab training and have gradually standardized the relevant procedures. Herein, we report our standardized training procedures using a goat and discuss its feasibility as a novel training model.METHODS:The standardized wet-lab training courses of laparoscopic liver resection conducted on 62 tables with a total of 70 goats were reviewed. The training course began by encircling the hepatoduodenal ligament for the Pringle maneuver, which was repeated during the parenchymal dissection. Following partial liver resection of the left lateral section, left hepatectomy was performed by a standardized procedure for humans in which the liver was split, exposing the entire length of the middle hepatic vein trunk from the dorsal side after extrahepatic transection of the left Glissonean pedicle. If a goat deceased before initiating left hepatectomy, the training was restarted with a new goat. The surgical procedures were performed by surgeons of varying skill levels.RESULTS:A total of 184 surgeons including 10 surgical residents participated in the training. Partial liver resection was initiated in 62 tables, with 8 (13%) dying during or after the procedure of partial liver resection. Subsequently, left hepatectomy was initiated in 61 and completed in 59 tables (98%), regardless of whether the goat survived or deceased, and was not completed in 2 tables (3%) due to time limitation. In 14 tables (23%), the goats deceased during the procedure, however, the procedure was completed. The causes of death were multifactorial, including massive bleeding, reperfusion injury after the Pringle maneuver, and carbon dioxide gas embolism.CONCLUSIONS:Left hepatectomy in a goat is useful as a training model for laparoscopic anatomic liver resection. |
| DOI | 10.1007/s00464-023-09864-4 |
| PMID | 36627539 |