Rapid learning curve assessment in an ex vivo training system for microincisional glaucoma surgery

Abstract Increasing prevalence and cost of glaucoma have increased the demand for surgeons well trained in newer, microincisional surgery. These procedures occur in a highly confined space, making them difficult to learn by observation or assistance alone as is currently done. We hypothesized that o...

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Autores principales:	Yalong Dang, Susannah Waxman, Chao Wang, Hardik A. Parikh, Igor I. Bussel, Ralitsa T. Loewen, Xiaobo Xia, Kira L. Lathrop, Richard A. Bilonick, Nils A. Loewen
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/42747e09f4204e239efafbe8d38df69b
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spelling	oai:doaj.org-article:42747e09f4204e239efafbe8d38df69b2021-12-02T12:32:29ZRapid learning curve assessment in an ex vivo training system for microincisional glaucoma surgery10.1038/s41598-017-01815-z2045-2322https://doaj.org/article/42747e09f4204e239efafbe8d38df69b2017-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-01815-zhttps://doaj.org/toc/2045-2322Abstract Increasing prevalence and cost of glaucoma have increased the demand for surgeons well trained in newer, microincisional surgery. These procedures occur in a highly confined space, making them difficult to learn by observation or assistance alone as is currently done. We hypothesized that our ex vivo outflow model is sensitive enough to allow computing individual learning curves to quantify progress and refine techniques. Seven trainees performed nine trabectome-mediated ab interno trabeculectomies in pig eyes (n = 63). An expert surgeon rated the procedure using an Operating Room Score (ORS). The extent of outflow beds accessed was measured with canalograms. Data was fitted using mixed effect models. ORS reached a half-maximum on an asymptote after only 2.5 eyes. Surgical time decreased by 1.4 minutes per eye in a linear fashion. The ablation arc followed an asymptotic function with a half-maximum inflection point after 5.3 eyes. Canalograms revealed that this progress did not correlate well with improvement in outflow, suggesting instead that about 30 eyes are needed for true mastery. This inexpensive pig eye model provides a safe and effective microsurgical training model and allows objective quantification of outcomes for the first time.Yalong DangSusannah WaxmanChao WangHardik A. ParikhIgor I. BusselRalitsa T. LoewenXiaobo XiaKira L. LathropRichard A. BilonickNils A. LoewenNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-9 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Yalong Dang Susannah Waxman Chao Wang Hardik A. Parikh Igor I. Bussel Ralitsa T. Loewen Xiaobo Xia Kira L. Lathrop Richard A. Bilonick Nils A. Loewen Rapid learning curve assessment in an ex vivo training system for microincisional glaucoma surgery
description	Abstract Increasing prevalence and cost of glaucoma have increased the demand for surgeons well trained in newer, microincisional surgery. These procedures occur in a highly confined space, making them difficult to learn by observation or assistance alone as is currently done. We hypothesized that our ex vivo outflow model is sensitive enough to allow computing individual learning curves to quantify progress and refine techniques. Seven trainees performed nine trabectome-mediated ab interno trabeculectomies in pig eyes (n = 63). An expert surgeon rated the procedure using an Operating Room Score (ORS). The extent of outflow beds accessed was measured with canalograms. Data was fitted using mixed effect models. ORS reached a half-maximum on an asymptote after only 2.5 eyes. Surgical time decreased by 1.4 minutes per eye in a linear fashion. The ablation arc followed an asymptotic function with a half-maximum inflection point after 5.3 eyes. Canalograms revealed that this progress did not correlate well with improvement in outflow, suggesting instead that about 30 eyes are needed for true mastery. This inexpensive pig eye model provides a safe and effective microsurgical training model and allows objective quantification of outcomes for the first time.
format	article
author	Yalong Dang Susannah Waxman Chao Wang Hardik A. Parikh Igor I. Bussel Ralitsa T. Loewen Xiaobo Xia Kira L. Lathrop Richard A. Bilonick Nils A. Loewen
author_facet	Yalong Dang Susannah Waxman Chao Wang Hardik A. Parikh Igor I. Bussel Ralitsa T. Loewen Xiaobo Xia Kira L. Lathrop Richard A. Bilonick Nils A. Loewen
author_sort	Yalong Dang
title	Rapid learning curve assessment in an ex vivo training system for microincisional glaucoma surgery
title_short	Rapid learning curve assessment in an ex vivo training system for microincisional glaucoma surgery
title_full	Rapid learning curve assessment in an ex vivo training system for microincisional glaucoma surgery
title_fullStr	Rapid learning curve assessment in an ex vivo training system for microincisional glaucoma surgery
title_full_unstemmed	Rapid learning curve assessment in an ex vivo training system for microincisional glaucoma surgery
title_sort	rapid learning curve assessment in an ex vivo training system for microincisional glaucoma surgery
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/42747e09f4204e239efafbe8d38df69b
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Rapid learning curve assessment in an ex vivo training system for microincisional glaucoma surgery

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