Search

Objective To explore the feasibility and rationality of advanced integrated two-stage laparoscopic simulation training course in standardized training of surgical residents. Methods From December 2019 to December 2021, the advanced integrated two-stage laparoscopic simulation training course was carried out among 2019—2020 surgical residents who received standardized training in our hospital. The course was divided into two stages. In the first stage, BEST (best essential surgical technology training) course, adopted Darwin® endoscopic training system, Tianyan® endoscopic training system, Microport® 3D laparoscopic training system and simple simulative models were used. The second stage, BEST PLUS course, same platform as that in BEST course and in vitro animal models were used. The questionnaire survey method (before and after class questionnaire) was adopted to evaluate the curriculum setting, such as curriculum form, simulators, teaching method, time arrangement, curriculum difficulty, training effect, curriculum satisfaction and so on. Results A total of 37 surgical residents completed the two-stage course training and the questionnaire survey. The overall satisfaction rate with the curriculum setting was 100%. There were 32 residents (86.5%) thought that first stage training course could significantly improve their clinical skills, 35 residents (94.6%) thought that second stage training course could significantly improve their clinical skills, and 36 resident (97.3%) thought that the first stage curriculum could significantly help them improve performance in the second stage curriculum. Conclusions The trainees had a high degree of recognition and satisfaction for the advanced integrated two-stage laparoscopic simulation training course. The overall design of course was reasonable and feasible, and was attractive to trainees.

Background The 'Learn, See, Practice, Prove, Do, Maintain' (LSPPDM) pedagogical framework is an evidence-based framework developed through a careful review and synthesis of the literature. The purpose of the study was to explore the effectiveness and applicability of the LSPPDM pedagogical framework in the laparoscopic training course for surgical residents. Methods Prospective study of surgical residents who underwent standardized surgical residency training in a single institution from December 2020 to December 2022. Trainees were randomized to either the pedagogical group (6-step LSPPDM pedagogical framework) or traditional group (2-step traditional approach with twice-weekly lectures and a weekly laparoscopic operating skills session). The Global Operative Assessment of Laparoscopic Skills scale was used for technical skills, and the Non-Technical Skills for Surgeons assessment form was used for non-technical skills. Results Sixty trainees were randomized. The pedagogical group scored higher on subjective perception (P < 0.050) and the theoretical assessment (mean(s.d.) 41.83(6.66)) than those in the traditional group (37.83(5.77)) (P = 0.016). Trainees in the pedagogical group took less time to complete the assessment of models, had fewer failures and higher scores, took less time to complete laparoscopic sutures and knots, showed better proficiency with laparoscopic instruments, and completed at higher quality (P < 0.050). Trainees performing laparoscopic cholecystectomy in animal models demonstrated higher technical and non-technical skill scores in the pedagogical group (P < 0.050). 'Tissue handling' and 'Decision making' were common areas for improvement for both groups of trainees. Conclusions The LSPPDM pedagogical framework is feasible and demonstrated improvements in technical and non-technical skills in surgical trainees compared to a traditional training programme. [ABSTRACT FROM AUTHOR]

Models that predict tool life based on wear mechanism knowledge are typically inaccurate, as the use of simplified model parameters can have a significant effect on this prediction. While a tool life prediction model based on sample cutting data is limited to specific working conditions, which makes tool life prediction difficult to generalize, and needs a large amount of historical data as support. In this paper, the empirical formula of tool life based on wear mechanism knowledge was combined with a neural network, which can significantly improve prediction accuracy. Firstly, a concept of tool life grade is proposed, and its classification standard is outlined. Secondly, a prediction model based on the empirical life formula and experimental data was established. Thirdly, a tool wear prediction model based on a convolutional neural network (CNN) was established through the real-time tool condition data, and the corresponding life compensation strategy can be determined by comparing this with the historical data. Finally, the empirical life grade was adjusted to obtain the real-time tool life grade. A case example shows that the data-driven knowledge-guided prediction model can significantly improve the recognition accuracy of tool life grade. [ABSTRACT FROM AUTHOR]

The radioactive particle chain is a linear array of 125I particles and placed in a tubular conduit. The dose distribution of the particle chain is similar to the shape of a cylinder. It may be adapted to the tumors in the lumen and exerts the radiotherapy effect that may not be achieved by single particles. This article aims to review the history of 125I radioactive particle chains, dose distribution, placement methods and clinical application.

Objectives: To evaluate the safety and effectiveness of computed tomography (CT)-guided radioactive 125I seeds brachytherapy (RISB) for lung oligometastases (LO) from colorectal cancer (CRC). Methods: Data for 144 LOs from 70 CRC patients who underwent CT-guided RISB were retrospectively analyzed. The primary endpoints were progression-free survival (PFS) and overall survival (OS), and the secondary endpoints were technical success, local control rate (LCR), and complications. Kaplan–Meier method was used for survival analysis. Cox model was used to identify the independent predictors of poor prognosis. Results: The RISB procedures were successfully performed in all patients, and the success rate was 100%. The median follow-up was 27.8 months. The median PFS was 10.0 months (95% CI: 8.9–11.1) and the 1- and 2-year PFS rates were 32.9% and 5.9%, respectively. On multivariate analysis, serum carcinoembryonic antigen (CEA) ≤ 15 ng/ml (P = 0.048), middle-high differentiated pathological classification (P = 0.015), primary TNM stages I-III (P = 0.001), LO number ≤ 2 (P < 0.001) and cumulative gross tumor volume (GTV) ≤ 40 cm3 (P < 0.001) showed superior PFS. The median OS was 30.8 months (95% CI: 27.1–34.4) and the 1-, 2-, and 3-year OS rates were 95.7%, 67.4%, and 42.5%, respectively. On multivariate analysis, serum CEA ≤ 15 ng/ml (P = 0.004), middle-high differentiated pathological classification (P < 0.001), primary TNM stages I-III (P < 0.001), LO number ≤ 2 (P < 0.001), cumulative GTV ≤ 40 cm3 (P < 0.001) and system treatments combined with chemotherapy and target therapy (P < 0.001) showed superior OS. The LCR for 3, 6, and 12 months was 97.9%, 91.0%, and 83.6%, respectively. There were 4 cases of pneumothorax at 5.7% that required drainage. Conclusions: RISB for LO from CRC is safe and effective, and serum CEA, TNM stage, LO number, cumulative GTV, and system treatments should be emphasized for long OS. Key points: • CT-guided RISB is a new treatment for lung oligometastases from CRC. • RISB can be an alternative therapy for patients who are unsuitable for surgery, ablation, or SBRT. • Serum CEA, TNM stage, LO number, cumulative GTV, and system treatments are prognostic factors. • RISB is a safe method with a curative effect. [ABSTRACT FROM AUTHOR]