Massachusetts Chapter of the American College of Surgeons

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Development and Validation of a Novel Surgical Simulator for Thyroid Lobectomy and Recurrent Laryngeal Dissection
Alexis Graham-Stephenson, Bharat Yarlagadda
Lahey Hospital, Burlington, MA

Background: Thyroid lobectomy can be a challenging surgery to learn, due to differences in tumor size, location, and involvement of the recurrent laryngeal nerve (RLN). Complications such as nerve weakness or dysfunction, tumor violation, and hematoma can result in serious quality of life issues and tumor control difficulty. The use of simulation can afford trainees additional exposure to this procedure prior to performance in the operating room.
Methods: Using silicone and 3D-printed materials, we designed a surgical simulator for thyroid lobectomy and recurrent laryngeal nerve dissection. The surgical trainer mimics the main steps of the procedure and important anatomic landmarks, while integrating the challenge of soft tissue dissection and nerve preservation. A circuited copper wire was used to replicated the RLN, indicating contact with instruments via audio feedback. Face validity was achieved using a post-simulation survey and subjective impressions of participants via a 1-5 Likert scale. Demographic information of participants was collected, including surgical specialty and level of prior experience with thyroid lobectomy and RLN dissection.
Results: 25 participants completed thyroid lobectomy on the simulator after watching a video demonstration. Mean total assessment scores were calculated using a 16-point procedure checklist. The majority of participants strongly agreed that junior or inexperienced residents would benefit from practicing on the model.
Conclusion: This model is the first reported conceptualized trainer for thyroid surgery. Low cost and ease of replication will enhance availability and contribute to the surgical education of trainees in a safe environment prior to participating in live surgery.


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