Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.170111
Jornal Vascular Brasileiro
Innovations

Balões de látex: um modelo alternativo e de baixo custo para treinamento de anastomoses vasculares no ensino médico

Latex balloons: an alternative, low-cost model for vascular anastomosis training in medical education

Priscilla Lopes Fonseca Abrantes Sarmento, André Loureiro Fernandes, Bruna Lisboa do Vale, Bruno D’Paula Andrade, Jennyfer Kellen Lázaro da Rocha, Jéssika da Silva Antas, Waleria Cristina de Abreu, Petrúcio Abrantes Sarmento

Downloads: 0
Views: 112

Resumo

O uso de simuladores na educação médica tem sido cada vez mais frequente, porém pouco acessíveis devido ao custo elevado. Foi desenvolvido para tal um modelo acessível e de baixo custo para o aprendizado e o treinamento de suturas e anastomoses vasculares em Laboratório de Bases das Técnicas Cirúrgicas. Foram utilizados balões de látex de cores variadas, fio de polipropileno 6.0 e outros materiais específicos para sutura vascular (porta-agulhas e pinças). Para facilitar o reparo dos balões, eles foram fixados em parafusos sobre placas de madeira. Foram feitas anastomoses terminoterminal, terminolateral e laterolateral e construção de patch. A perviedade da anastomose foi testada a partir da injeção de água em uma extremidade do balão e a observação da saída do conteúdo líquido na extremidade oposta. As vantagens observadas nesse modelo de treinamento para anastomoses foram a maleabilidade, a resistência à passagem do fio e o fato de ser inorgânico. Os balões de látex são uma alternativa barata, viável, não perecível e de uso prolongado no ensino e treinamento das suturas e anastomoses arteriais.

Palavras-chave

educação de graduação em medicina; procedimentos cirúrgicos vasculares; anastomose cirúrgica; modelos anatômicos.

Abstract

Simulators are increasingly being used in medical education, but accessibility is restricted by their elevated cost. A accessible and low-cost model was developed for teaching and learning vascular sutures and anastomoses at a Basic Surgical Techniques Laboratory. Latex balloons of varying colors, polypropylene 6.0 sutures, and other materials specifically for suturing (needle holder and forceps) were used. The balloons were fixed to screws inserted into wooden boards in order to facilitate repairs. E end-to-end, end-to-side, and side-to-side anastomoses and patching were performed. Anastomosis patency was tested by injecting water into one extremity of the balloon and observing the liquid exit via the opposite extremity. The advantages observed with this training model for anastomoses were malleability, resistance to passage of the suture, and the fact that it is inorganic. Latex balloons are an inexpensive option that are non-perishable and offer prolonged use for teaching and practice of arterial sutures and anastomoses.

Keywords

education, medical, undergraduate; vascular surgical procedures; anastomosis, surgical; models, anatomic.

References

1. Achar RA, Lozano PA, Achar BN, Pereira GV Fo, Achar E. Experimental model for learning in vascular surgery and microsurgery: esophagus and trachea of chicken. Acta Cir Bras. 2011;26(2):101-6. http://dx.doi.org/10.1590/S0102-86502011000200005. PMid:21445471.

2. Grahem H, Teixeira RK, Feijo DH, et al. Treinamento de anastomoses vasculares de baixo custo: o cirurgião vai à feira. J Vasc Bras. 2017;16(3):262-6. http://dx.doi.org/10.1590/1677-5449.000817.

3. Rodriguez JR, Yañez R, Cifuentes I, Varas J, Dagnino B. Microsurgery workout: a novel simulation training curiculum based on nonliving models. Plast Reconstr Surg. 2016;138(4):739-47. http://dx.doi.org/10.1097/PRS.0000000000002456. PMid:27673544.

4. Jaeger M, Ely PB, Pires JA, Ferreira LM. An experimental model to retraining in microvascular suture. Acta Cir Bras. 2014;29(Suppl 2):1-5. http://dx.doi.org/10.1590/S0102-86502014001400001. PMid:25229506.

5. Maluf I Jr, Silva AB, Groth AK, et al. An alternative experimental model for training in microsurgery. Rev Col Bras Cir. 2014;41(1):72-4. http://dx.doi.org/10.1590/S0100-69912014000100014. PMid:24770778.

6. Petroianu A. Ethical aspects in research on animals. Arch Surg. 1996;11:157-64.

7. Carrel A. La téchnique opératoire des anastomoses vasculaires et la transplantation de viscères. Lyon: Association Typographique; 1902.

8. Carrel A. The surgery of blood vessels. Baltimore: Johns Hopkins Med.; 1907.

9. Carrel A. Heterotransplantation of blood vessels preserved in cold storage. J Exp Med. 1907;9(2):226-8. http://dx.doi.org/10.1084/jem.9.2.226. PMid:19867084.

10. Guthrie CC. Some physiologic aspects of blood vessels surgery. JAMA. 1908;51:1568-2.

11. Rutherford RB. Atlas of vascular surgery: basic techniques and exposures. Vol. 1. Philadelphia: WB Saunders; 2000. p. 486-93.

12. Carrel A. Results of transplantation of blood vessels organs and limbs. JAMA. 1908;51(20):1662-7.

13. Kallás IE, Kallás AC, Kallás E. Anastomoses arteriais: passado, presente e futuro. Acta Cir Bras. 1999;14(4):221-7. http://dx.doi.org/10.1590/S0102-86501999000400013.

14. Sigounas V, Callas PW, Nicholas C, et al. Evaluation of simulation based training model on vascular anastomotic skills for surgical residents. Simul Healthc. 2012;7(6):334-8. http://dx.doi.org/10.1097/SIH.0b013e318264655e. PMid:22960701.

15. Wilasrusmee C, Lertsithichai P, Kittur DS. Vascular anastomosis model: relation between competency ia a laboratory -based model and surgical competence. Eur J Vasc Endovasc Surg. 2007;34(4):405-10. http://dx.doi.org/10.1016/j.ejvs.2007.05.015. PMid:17681827.

16. Okhah Z, Morrissey P, Harrington DT, Cioffi WG, Charpentier KP. Assessment of surgical residents in a vascular anastomosis laboratory. J Surg Res. 2013;185(1):450-4. http://dx.doi.org/10.1016/j.jss.2013.04.090. PMid:23800439.

17. Martins PNA, Montero EFS. Basic microsurgery training: comments and proposal. Acta Cir Bras. 2007;22(1):79-81. http://dx.doi.org/10.1590/S0102-86502007000100014. PMid:17293955.

18. Webster R, Ely PB. Treinamento em microcirurgia vascular: é economicamente viável? Acta Cir Bras. 2002;17(3):194-7. http://dx.doi.org/10.1590/S0102-86502002000300008.

19. Lima DA, Galvão MSL, Cardoso MM, Leal PRA. Laboratory training program in microsurgery at the National Cancer Institute. Rev Bras Cir Plást. 2012;27(1):141-9. http://dx.doi.org/10.1590/S1983-51752012000100024.

20. Colpan ME, Slavin KV, Amin-Hanjani S, Calderon-Arnuphi M, Charbel FT. Microvascular anastomosis training model based on a Turkey neck with perfused arteries. Neurosurgery. 2008;62(5, Suppl 2):407-10. PMid:18596522.

5cd1c72b0e88253f3f632f8e jvb Articles

J Vasc Bras

Share this page
Page Sections