Acessibilidade / Reportar erro

ENDOSCOPIC INTERLAMINAR DISCECTOMY. USE OF SWINE CADAVERS AS A TRAINING MODEL

DISCECTOMIA INTERLAMINAR ENDOSCÓPICA. USO DE CADÁVERES DE SUÍNOS COMO MODELO DE TREINAMENTO

DISCECTOMÍA INTERLAMINAR ENDOSCÓPICA. USO DE CADÁVERES DE CERDOS COMO MODELO DE ENTRENAMIENTO

ABSTRACT

Objective:

To analyze the possibility of using cadavers of pigs for training in endoscopic interlaminar discectomy.

Methods:

Five young pigs were used. The necessary instruments and equipment were used, and the endoscopic transforaminal and interlaminar percutaneous approach was performed at the L7-S1 level. A specialist surgeon performed the procedure. The points of entry, needle angulation, and subjective technical difficulties indicated by the surgeon were analyzed.

Results:

The mean weight of pigs was 42.2 kg. The posterolateral (transforaminal) entry point was, on average, 6.28 cm from the midline at an angulation of 32.8°. The posterior (interlaminar) entry point was on average 1.82 cm. Full-endoscopic interlaminar discectomy was possible in all animals of the sample. The structures described in the literature were visible endoscopically in 100% of the models.

Conclusions:

The demonstrated benefits and increased indications of endoscopic lumbar surgery created the need to establish safer and more efficient training processes. The authors raise the possibility of using experimental models to develop technical skills in endoscopy via interlaminar approach. The use of teaching tools such as animal models constitutes a new learning technique and give more confidence to surgeons. The use of cadavers of pigs, obtained according to ethics, avoids the use of human cadavers, and minimizes the development of the learning curve on patients.

Keywords:
Education, continuing; Minimally invasive surgical procedures; Diskectomy; Endoscopy; Swine; Ethics.

Sociedade Brasileira de Coluna Al. Lorena, 1304 cj. 1406/1407, 01424-001 São Paulo, SP, Brasil, Tel.: (55 11) 3088-6616 - São Paulo - SP - Brazil
E-mail: coluna.columna@uol.com.br