Validação de modelo híbrido de placenta humana modificada para treinamento de anastomose entre artéria temporal superficial e artéria cerebral média

• Ano de defesa: 2023
• Autor(a) principal: Carlos Eduardo Prata Fernandes Ferrarez
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Minas Gerais; Brasil; MEDICINA - FACULDADE DE MEDICINA; Programa de Pós-Graduação em Ciências Aplicadas à Cirurgia e à Oftalmologia; UFMG
• Palavras-chave em Português: Bypass cerebrovascular; Microneurocirurgia.; Simulação neurocirúrgica; Bypass da artéria temporal superior-artéria cerebral média; Validação de conteúdo; Validação de construto; Validação concorrente; Ponte de Artéria Coronária; Neurocirurgia; Treinamento por Simulação; Estudo de Validação; Placenta
• Link de acesso: http://hdl.handle.net/1843/64951

Introduction: Superficial temporal artery-to-middle cerebral artery bypass is a valuable revascularization technique for adult moyamoya disease, carotid artery occlusion that fails medical therapy, and complex aneurysms. Cerebrovascular bypass surgical procedures involve the use of significant technical bimanual skills. Neurosurgeons traditionally practice in the live rat model. The use of a hybrid ex-vivo simulator that has all ATS-ACM bypass microsurgery part tasks is explored. Material and Methods: Three human placentas and a synthetic skull composed one ex vivo hybrid simulator. Six cerebrovascular neurosurgeons (especialistas) and six general neurosurgeons participated in this study divided in 2 groups. Face and content validity used a questionnaire answered by especialistas regarding simulator similarities with real surgery (vessel dissection, Sylvian fissure opening, deep and narrow work field and end to side anastomosis). Construto validity compared both groups measuring total time, occurrence of vessel lesions during dissection and bypass patency. Statistical analysis was performed. Concurrent validity confronted characteristics between the ex vivo hybrid, flat models (live rat, chicken wing, human placenta and synthetic tube) and human cadaver head simulators for ATS-ACM bypass microsurgery. Results: All human placentas were suitabela to simulate the ATS-ACM bypass. Face and content validity showed high fidelity to real surgery. Construto validity showed significant statistical difference between não especialista and especialistas (p<.005). Concurrent validity highlighted that all ATS-ACM part tasks are present in the ex-vivo hybrid simulator when compared to flat models and cadaver head. Conclusion: Ex vivo hybrid simulation model has strong face, content, construto and concurrent validity, and is the only ATS-ACM bypass simulator that explores all surgical part tasks. Shortening the bypass learning curve working with the hybrid simulator is a training model promise, but needs predictive validity data to be assured.