OBJECTIVE To evaluate muscle activity and hand motion in veterinarians performing a standard set of laparoscopic training tasks.
SAMPLE 12 veterinarians with experience performing laparoscopic procedures.
PROCEDURES Participants were asked to perform peg transfer, coordination, precision cutting, and suturing tasks in a laparoscopic box trainer. Activity of the right biceps brachii, triceps brachii, forearm flexor, forearm extensor, and trapezius muscles was analyzed by means of surface electromyography. Right hand movements and wrist angle data were registered through the use of a data glove, and risk levels for the wrist joint were determined by use of a modified rapid upper limb assessment (RULA) method. One-way repeated-measures ANOVA with a Bonferroni post hoc test was performed to compare values between tasks.
RESULTS Activity in the biceps muscle did not differ significantly among the 4 tasks. Activity in the triceps, forearm flexor, and forearm extensor muscles was significantly higher during precision cutting than during the coordination task. Activity in the trapezius muscle was highest during the suturing task and did not differ significantly among the other 3 tasks. The RULA score was unacceptable (score, 3) for the coordination, peg transfer, and precision cutting tasks but was acceptable (score, 2) for the suturing task.
CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that the ergonomics of laparoscopic training depended on the tasks performed and the design of the instruments used. Precision cutting and suturing tasks were associated with the highest muscle activity. Acceptable wrist position, as determined with the RULA method, was found with the suturing task, which was performed with an axial-handled instrument. (Am J Vet Res 2016;77:186–193)
OBJECTIVE To compare the usefulness of fresh-frozen canine cadavers (FFCCs) and a validated canine simulator model for training veterinary students in basic gastrointestinal endoscopic procedures.
DESIGN Randomized trial.
SAMPLE 48 veterinary students in their final year of training.
PROCEDURES Students were randomly assigned to receive basic gastrointestinal endoscopic training on a canine simulator or FFCC. All students were trained as assigned in esophagogastroduodenoscopy, endoscopic gastric biopsy, and gastric foreign body removal for 2 h/d for 5 days. They then performed each procedure on a live dog, and procedure completion time and performance ability were compared between groups. Two experienced endoscopists used a validated Likert-type procedural rating scale to rate the students' performance. Students completed a survey to rate their training model.
RESULTS No significant differences were identified between groups in quality of performance of the 3 endoscopic procedures on a live dog. Students required significantly less time to complete the procedures on a live dog when trained on an FFCC versus canine simulator. Although both training models were considered equally useful by students, training on the simulator was significantly more stimulating.
CONCLUSIONS AND CLINICAL RELEVANCE Students showed the same skill level in performing basic endoscopic procedures on live dogs regardless of the training model used, although students who trained on the FFCC completed these procedures faster than students trained on the canine simulator. Use of the simulator appeared to be a viable alternative to use of FFCCs for veterinary endoscopic training, providing students with a good level of proficiency before performing endoscopic procedures on live dogs.
Objective—To evaluate the use of ultrasonography to
detect morphologic changes in the pylorus during
pyloroplasty performed laparoscopically or via conventional
abdominal surgery in dogs.
Animals—10 healthy mixed-breed dogs.
Procedure—Laparoscopic ultrasonography of the
pylorus was performed in 5 dogs during laparoscopic
pyloroplasty (LP), and ultrasonography of the pylorus
was performed in 5 dogs during pyloroplasty via conventional
abdominal surgery (CAP group).
Appearance and dimensions of the pyloric sphincter
were evaluated by use of a 7.5-MHz flexible laparoscopic
Results—Mean ± SD duration of the ultrasonographic
procedure was 11 ± 3.04 minutes (range, 6 to 18 minutes).
In the CAP group, cross-sectional views of the
pylorus revealed significant differences between the
overall transverse external diameter, overall craniocaudal
external diameter, and transverse diameter of the
pyloric lumen. After surgery, the pyloric area was significantly
increased. Longitudinal views of the pylorus
revealed that width of the pyloric ring was significantly
less after surgery. Transverse views of the pylorus
for the LP group revealed a significant increase in the
transverse diameter and craniocaudal diameter of the
pyloric lumen after LP. The pyloric area was also significantly
increased after surgery. Longitudinal views of
the pylorus revealed that width of the pyloric ring was
significantly less after surgery. Transverse diameter of
the pyloric lumen was significantly increased after LP.
Conclusions and Clinical Relevance—Analysis of
results of this study suggests that ultrasonography is
useful for detecting relevant morphologic changes in
the pyloric sphincter after pyloroplasty. (Am J Vet Res 2003;64:1099–1104)