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Purpose: The present knowledge about lymphatic drainage of the ovary is based on carcinological studies, but it has only rarely been studied under physiological conditions. However, it is one of the preferential routes of dissemination in ovarian cancer, and understanding it is therefore vital for optimal carcinological management.Our purpose was to evaluate the feasibility of an innovative technique to study the lymphatic drainage territories of the ovary using a recirculation module on the cadaveric model. Methods: We injected patent blue into the cortex of twenty "revascularised" cadaver ovaries with the Simlife recirculation model. We observed the migration of the dye live and described the drainage territories of each ovary. Results: We observed a staining of the lymphatic vessels and migration of the dye in all the subjects, systematically ipsilateral to the injected ovary. We identified a staining of the lumbo-aortic territory in 65% of cases, with a preferential lateral-caval involvement (60%) for the right ovary and lateral-aortic territory (40%) for the left ovary. A common iliac involvement was observed in only 10% of cases. In 57% of cases, the staining of the lumbo-aortic territory was associated with a staining of the suspensory ligament. The pelvic territory was involved in 50% of cases, with an external iliac staining in 25% of cases and internal in 20%. Conclusion: Our study provides for a better understanding of lymphatic drainage of the ovary using a new detection method, and allows the possibility of improving the teaching for operators with a realistic model. Continuation of this work could lead to considering more targeted and thus less morbid lymph node sampling for lymph node staging in early-stage ovarian cancer. [ABSTRACT FROM AUTHOR]

To evaluate the validity and reliability of an innovative training model for endocrine surgical procedures. A simulator training model for endocrine procedures (SimLife) was developed at an academic center. The model consisted of a realistic operating environment with a coherent simulated patient dynamized by pulsatile vascularization with simulated blood warmed to 37 °C, and ventilation. Training sessions were designed for adrenal and thyroid surgery, as well as neck dissection. The primary outcome of interest was to evaluate learners' performance and satisfaction. Learners' performance was evaluated based on a scoring scale that followed the Downing method for the assessment of competency. While learners' satisfaction was evaluated using a Likert scale of 1 to 10 on four items (ease of learning, anatomic correspondence of landmarks, realism, and overall satisfaction). Participants were engaged in 32 training sessions. These included 24 adrenalectomies (conventional and laparoscopic both transabdominal and posterior), and 4 thyroid lobectomies with concomitant functional lateral compartment neck dissection. competency scores were procedure-specific addressing specific core components of a given procedure. Learners' performance scored above average in all procedures evaluated. Satisfaction scores for the specified four items ranged between 8.43 (SD 0.87) and 8.89 (SD 0.96). No major events were reported for the adrenalectomies, while only one jugular vein injury occurred during neck dissection. SimLife is a hyper-realistic training model that allows for satisfactory acquisition of skills and the evaluation of performance progression. It has the potential to become a cornerstone in specialized surgical training. [ABSTRACT FROM AUTHOR]

Background: The demand for bariatric surgery is high and so is the need for training future bariatric surgeons. Bariatric surgery, as a technically demanding surgery, imposes a learning curve that may initially induce higher morbidity. In order to limit the clinical impact of this learning curve, a simulation preclinical training can be offered. The aim of the work was to assess the realism of a new cadaveric model for simulated bariatric surgery (sleeve and Roux in Y gastric bypass). Aim: A face validation study of SimLife, a new dynamic cadaveric model of simulated body for acquiring operative skills by simulation. The objectives of this study are first of all to measure the realism of this model, the satisfaction of learners, and finally the ability of this model to facilitate a learning process. Methods: SimLife technology is based on a fresh body (frozen/thawed) given to science associated to a patented technical module, which can provide pulsatile vascularization with simulated blood heated to 37 °C and ventilation. Results: Twenty-four residents and chief residents from 3 French University Digestive Surgery Departments were enrolled in this study. Based on their evaluation, the overall satisfaction of the cadaveric model was rated as 8.52, realism as 8.91, anatomic correspondence as 8.64, and the model's ability to be learning tool as 8.78. Conclusion: The use of the SimLife model allows proposing a very realistic surgical simulation model to realistically train and objectively evaluate the performance of young surgeons. [ABSTRACT FROM AUTHOR]